桡神经损伤的修复与功能重建

目的 探讨桡神经损伤后的修复方法与效果。方法 对1990年-2000年收治的50例因各种原因所致的桡神经损伤患者的治疗方法与效果进行总结，其中刀伤18例，玻璃割伤4例，肱骨中下段骨折16例，肱骨髁间骨折4例，于是错骨折6例，肘关节开放性脱位1例，桡骨小头粉碎性骨折1例，50例中，完全断裂28例，不完全断裂3例，卡压10例，挫伤5例，不可逆损伤4例，均于伤后1小时-6个月内作神经探查，行神经吻合31例，神经松解10例，肌腱移位4例，自行恢复5例。结果 50例均获得3个月-10年随访，按Highet运动分级法评定，优：M4以上，良：M3，可：M2，差：M1或M0。50例中优良46例，占92%，可4例。结论 对桡神经损伤者确诊后应尽快手术探查，行神经吻合，松解，可获得满意效果。对不可逆损伤在6个月以上，应行肌腱移位重建伸腕，伸拇及伸指功能。

REPAIR AND RECONSTRUCTION OF RADIAL NERVE INJURY

Objective To investigate the reparative method and effect of r adial nerve injury. Methods From 1990 to 2000, 50 cases wi th radial nerve in juries were adopted in this study. Among them, there were 38 males and 12 female s, aged from 5 to 65 years. For the 50 cases, there were 28 cases with complete nerve rupture, 3 cases with incomplete nerve rupture, 10 cases with compressive injury, 5 cases with contusion injury and 4 cases with defect and irreversible i njury. All the patients were treated with radial nerve exploration in 1 hour to 6 months after injury. 31 cases were treated with nerve anastomosis, 10 cases wi th nerve lytic operation, 4 cases with tendon transfer and 5 cases with palliati ve treatment. Results All the cases were followed up 3 mont hs to 10 years. Th e curative effect was assessed according to Highet grade method. There were exce llent and good results in 46 cases, moderate results in 4 cases. Conclus ion I t is necessary to explore and repair the radial nerve injury immediately after t he diagnosis being confirmed. If the function of radial nerve could not recover in 6 months, tendon transfer should be carried out to reconstruct the extension of elbow, thumb and fingers.