Önkol kombine sinir-tendon yaralanmalarında sinir tamiri sonuçlarımız
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Tarih
2004
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info:eu-repo/semantics/openAccess
Özet
AMAÇ Önkolda kombine sinir-tendon lezyonu olan olgularda yapılan sinir tamirinin klinik ve fonksiyonel sonuçları değerlendirildi. GEREÇ VE YÖNTEM Önkolda kombine sinir ve tendon kesişi saptanan 68 hasta (58 erkek, 10 kadın; ort. yaş 33.5; dağılım 5-48) retrospektif olarak incelendi. Olgularda uygulanan periferik sinir tamiri sayısı 96 idi. Sinir defekti olan hastalar çalışmaya alınmadı. Yaralanma, 17 hastada median ve ulnar sinirde, 17 hastada median, 34 hastada ulnar sinirdeydi. Hastalar, yaralanmadan ortalama dört saat (dağılım 20 dakika-24 saat) sonra ameliyata alındı. Altmış hastada primer sinir tamiri, sekiz hastada sekonder tamir uygulandı. On sekiz hastada interfasiküler dikiş, 50 hastada epiperinöral dikiş tekniği kullanıldı. Tüm hastalara ameliyat sonrası dönemde Washington rejimi ile rehabilitasyon uygulandı. Hastalar, fonksiyonel değerlendirme yöntemlerini içeren modifiye MRC (Medical Research Council) sınıflandırması ile değerlendirildi. Takip süresi en az iki yıl idi. Modifiye MRC sonuçları, yalnız median sinir kesişi olan 17 hastanın 10'unda çok iyi, yedisinde iyi; yalnız ulnar sinir kesişi olan 34 hastanın dokuzunda mükemmel, 10'unda çok iyi, 10'unda iyi, beşinde zayıf; median ve ulnar sinir kesişi tamiri yapılan 17 hastanın dördünde mükemmel, yedisinde çok iyi, altısında iyi bulundu. Altmış bir hastada (%89.7) tatmin-kar sonuç elde edildi. Yaş ile MRC sonuçları arasında anlamlı ilişki bulundu (p0.016). SONUÇ Önkol kombine sinir-tendon kesilerinde primer tamir ve erken hareket ile büyük oranda mükemmel ve tatmin edici sonuç elde edilebilmektedir.
BACKGROUND We evaluated the clinical and functional results of nerve repair in patients with combined tendon-nerve injuries of the forearm. The study included 68 patients (58 males, 10 females; mean age 33.5 years; range 5 to 48 years) with combined tendon-nerve injuries of the forearm. A total of 96 nerves were repaired. Patients with nerve defects were excluded. Both median and ulnar nerves were injured in 17 patients; median and ulnar nerve injuries were detected in 17 patients and 34 patients, respectively. The mean time to operation was four hours (range 20 nün to 24 h). Primary nerve repair was performed in 60 patients, and secondary repair was performed in eight patients. The interfascicular technique was employed in 18 patients, and epiperineural suture in 50 patients. Rehabilitation included early motion using the Washington regimen. A modified MRC (Medical Research Council) motor and sensory classification system was used for postoperative evaluation. The mean follow-up was at least two years. The modifıed MRC results were as follows: of 17 patients with median nerve injuries, 10 had excellent, seven had good results. Of 34 patients with ulnar nerve injuries, the results were excellent in nine, very good in 10, good in 10, and fair in fıve patients. Of those with median and ulnar nerve injuries, four, seven, and six patients had excellent, very good, and good results, respectively. Overall, 61 patients (89.7%) had satisfactory results. A significant correlation was found between age and the MRC results (p0.016). Primary nerve repair follovved by early motion results in substantial rates of excellent and satisfactory results in patients with combined nerve-tendon injuries.
BACKGROUND We evaluated the clinical and functional results of nerve repair in patients with combined tendon-nerve injuries of the forearm. The study included 68 patients (58 males, 10 females; mean age 33.5 years; range 5 to 48 years) with combined tendon-nerve injuries of the forearm. A total of 96 nerves were repaired. Patients with nerve defects were excluded. Both median and ulnar nerves were injured in 17 patients; median and ulnar nerve injuries were detected in 17 patients and 34 patients, respectively. The mean time to operation was four hours (range 20 nün to 24 h). Primary nerve repair was performed in 60 patients, and secondary repair was performed in eight patients. The interfascicular technique was employed in 18 patients, and epiperineural suture in 50 patients. Rehabilitation included early motion using the Washington regimen. A modified MRC (Medical Research Council) motor and sensory classification system was used for postoperative evaluation. The mean follow-up was at least two years. The modifıed MRC results were as follows: of 17 patients with median nerve injuries, 10 had excellent, seven had good results. Of 34 patients with ulnar nerve injuries, the results were excellent in nine, very good in 10, good in 10, and fair in fıve patients. Of those with median and ulnar nerve injuries, four, seven, and six patients had excellent, very good, and good results, respectively. Overall, 61 patients (89.7%) had satisfactory results. A significant correlation was found between age and the MRC results (p0.016). Primary nerve repair follovved by early motion results in substantial rates of excellent and satisfactory results in patients with combined nerve-tendon injuries.
Açıklama
Anahtar Kelimeler
Kaynak
Ulusal Travma Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
1
