中国现代手术学杂志2023，Vol.27Issue(5)：387-390,4.DOI:10.16260/j.cnki.1009-2188.2023.05.008
桡神经浅支移植修复肱骨干骨折术后医源性桡神经断裂损伤
Superficial branch of radial nerve autografting to repair iatrogenic radial nerve rupture after humeral shaft fracture fixation
摘要
Abstract
Objective To explore clinical efficacy of superficial branch of radial nerve transplantation to repair iatrogenic radial nerve rupture after humeral shaft fracture fixation.Methods A retrospective analysis was carried out in 6 cases(aged from 21 to 48)with iatrogenic radial nerve rupture after humeral shaft fracture fixation surgery from June 2012 to June 2018.The injury located on the left in 1 case and on the right in 5 cases.There were 2 cases of closed fracture and 4 cases of open fracture,and intramedullary nailing fixation in 1 case,plate fixation in 2 cases and external fixation in 3 cases.All injuries of iatrogenic radial nerve were repaired by autografting of double superficial radial nerve branches.The effect was evaluated by Nerve Injuries Committee of the British Medical Research Council(BMRC)standard.Results The radial nerve was directly interrupted by distal locking nail in 1 patient,compressed by distal steel plate in 2 patients,and nosed by distal external fixation pin in 3 patients.The defect length of radial nerve ranged from 7 to 9 cm,and the grafting length of superficial branch of radial nerve ranged from 14 to 18 cm.All patients were followed up for 24 to 36 months,with an average of 28 months.All wounds achieved primary healing without infection.According to BMRC standard,the function was excellent in 1 case,good in 4 cases and fair in 1 case,and the fineness rate was83.3%.All cases were found sensory numbness of thumb-index web due to harvest of superficial branch of radial nerve.Conclusions Iatrogenic injury of radial nerve would be avoided based on complete exposing of radial nerve during the fixation of humeral shaft fracture.For the patients with iatrogenic radial nerve rupture,satisfactory results can be achieved by transplantation of superficial branch of radial nerve.关键词
桡神经断裂,医源性/桡神经浅支移植/肱骨骨折Key words
radial nerve rupture,iatrogenic/superficial radial nerve transplantation/humerus fractures引用本文复制引用
冒海军,王震,许光跃..桡神经浅支移植修复肱骨干骨折术后医源性桡神经断裂损伤[J].中国现代手术学杂志,2023,27(5):387-390,4.基金项目
江苏省医学创新中心基金资助项目(CXZX202214) （CXZX202214）
