Type I Collagen Nerve Conduits for Median Nerve Repairs in the Forearm
Type I Collagen Nerve Conduits for Median Nerve Repairs in the Forearm
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DOI：
10.1016/j.jhsa.2013.03.028
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发表时间：
2013-06-01
影响因子：
1.9
通讯作者：
Prantl, Lukas
中科院分区：
文献类型：
--
作者：
Dienstknecht, Thomas;Klein, Silvan;Prantl, Lukas
目的评价1型胶原神经导管治疗前臂远端正中神经损伤患者的情况。方法对9例前臂远端正中神经损伤患者进行1型胶原神经导管治疗。神经间隙在1至2厘米之间。一名独立观察员在治疗后对患者进行了重新检查，最短随访时间为 14 个月，平均随访时间为 21 个月。使用视觉模拟量表评估残余疼痛。通过评估静态 2 点辨别力、相对于未受伤肢体的神经传导速度以及手臂、肩部和手部残疾结果测量评分来量化功能结果。我们还记录了生活质量指标，包括患者对结果的满意度和重返工作岗位的延迟时间。结果我们没有观察到与种植体相关的并发症。 9 名患者中，7 名没有疼痛，平均视觉模拟评分为 0.6。手臂、肩部和手部的平均残疾评分为 6 分。3 名患者的静态 2 点辨别力小于 6 毫米，4 名患者的静态 2 点辨别力在 6 至 10 毫米之间，2 名患者的静态 2 点辨别力超过 10 毫米。六名患者达到 M4 或更高状态。 8名患者对手术感到满意并愿意再次接受手术。结论本研究表明纯化1型牛胶原导管是修复前臂远端正中神经的一种实用且有效的方法。 （美国手外科学会版权所有 (C) 2013。保留所有权利。）
Purpose To evaluate patients with median nerve damage in the distal forearm treated with type 1 collagen nerve conduits.Methods Nine patients with damage to the median nerve in the distal forearm underwent treatment with a type 1 collagen nerve conduit. The nerve gaps ranged between 1 and 2 cm. An independent observer reexamined patients after treatment at a minimal follow-up of 14 months and a mean follow-up of 21 months. Residual pain was evaluated using a visual analog scale. Functional outcome was quantified by assessing static 2-point discrimination, nerve conduction velocity relative to the uninjured limb, and Disabilities of the Arm, Shoulder, and Hand outcome measure scoring. We also recorded quality of life measures including patients' perceived satisfaction with the results and return to work latency.Results We observed no implant-related complications. Of 9 patients, 7 were free of pain, and the mean visual analog scale was 0.6. The mean Disabilities of the Arm, Shoulder, and Hand score was 6. The static 2-point discrimination was less than 6 mm in 3 patients, between 6 and 10 mm in 4 patients, and over 10 mm in 2 patients. Six patients reached a status of M4 or higher. Eight patients were satisfied with the procedure and would undergo surgery again.Conclusions This study indicates that purified type 1 bovine collagen conduits are a practical and efficacious method for the repair of median nerves in the distal forearm. (Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved.)