外伤性桡神经损伤56例回顾与分析

目的总结外伤性桡神经损伤的临床特点和治疗经验。方法对56例外伤性桡神经损伤的临床资料进行回顾性分析。15例为上肢骨折合并桡神经损伤。其中肱骨中段骨折9例,肱骨髁上骨折4例,尺桡骨骨折2例;15例桡神经深支损伤,其中刀砍伤12例,尺桡骨骨折2例,机器绞伤1例。手术采用神经端端缝合术(外膜、束膜缝合)、神经内外松解术、神经移植术3种方法修复。结果56例术后随访1￣4年,平均1年8个月。按中华医学会手外科学会上肢部分功能评定试用标准评定,优良率达94.6%。结论早期手术及系统的康复训练,能够增进桡神经功能恢复。

A retrieval study and analysis of 56 cases traumatic radial nerve injuries

Objective To summarize clinical feature and treatment experience of traumatic radial nerve injury. Methods 56 cases of traumatic radial nerve injury was carried out. 15 cases of upper extremity fractures were accompanied with radial nerve injury. Among them, 9 cases of middle shaft humeral fractures, 4 cases of epicondylar humeral fractures and 2 cases of ulnar styloid fractures; 15 cases of radial nerve deep branch injury, which including 12 cases knife injuries, 2 cases of styloid fractures and 1 case of machine twist injury. End to end neurorrhaphy (epineurium, perineurium), neurolysis and nerve transplantation were applied to repair those injuries. Results A 1~4 year follow up was carried out on such 56 cases with a mean follow up time of 20 months. According to the upper extremity functional evaluation standard set up by hand surgery branch of Chinese Medical Association, 94.6% of fineness was reached. Conclusion Early operational intervention and systematic rehabilitation can help injured radial nerve functional recovery.