Abstract

Purpose

Single and double fascicular nerve transfer using the ulnar or median nerve is performed to restore elbow flexion following injuries to the brachial plexus or nerve root. However, little is known regarding the postoperative changes involved in the sensory alteration of the hand after a single and double fascicular nerve transfer. We evaluated the sensory alteration of the hand in patients who underwent single and double fascicular nerve transfer for two years.

Methods

A total of five patients that underwent single or double fascicular nerve transfer participated in this study. The injury mechanism was avulsion (n = 2), stretching (n = 1), open injury (n = 1), and compression (n = 1). The touch sensation of the index and the little fingers before surgery at 6 months, 1 year, and 2 years after nerve transfer was evaluated using the Semmes-Weinstein monofilaments test (SWM-t). Muscle strength of the elbow flexion and the wrist flexion was evaluated.

Results

The touch sensation of the index finger at 24 months was equal to the preoperative evaluation. On the other hand, the touch sensation of the little finger at 24 months slightly improved compared to what it had been at the preoperative evaluation. Moreover, the median of the SWM-t score in the index and little finger at 24 months after surgery was beyond 3.61 that mean diminished light touch level.

Conclusions

The results of this study indicate that the touch sensory deficit of the index and little fingers persist for up to 2 years after nerve transfer.

中文翻译：

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使用来自正中神经和尺神经的伴随神经转移重建肘关节屈曲后的手指感觉障碍。

摘要

目的

使用尺神经或正中神经进行单束和双束神经转移，以在臂丛神经或神经根受伤后恢复肘部屈曲。然而，关于单束神经和双束神经转移后手部感觉改变所涉及的术后变化知之甚少。我们评估了接受单束神经和双束神经转移两年的患者的手部感觉改变。

方法

共有 5 名接受单或双束神经转移的患者参与了这项研究。损伤机制为撕脱（n  =2）、拉伸（n  =1）、开放性损伤（n  =1）和压迫（n  =1）。使用 Semmes-Weinstein 单丝试验 (SWM-t) 评估神经移植后 6 个月、1 年和 2 年手术前食指和小指的触感。评估肘关节屈曲和腕关节屈曲的肌肉力量。

结果

24个月时食指触感与术前评价相同。另一方面，与术前评估相比，24 个月时小指的触感略有改善。此外，手术后 24 个月食指和小指的 SWM-t 评分中位数超过 3.61，这意味着轻触水平下降。

结论

这项研究的结果表明，食指和小指的触觉缺陷在神经转移后持续长达 2 年。