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ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2010, Number 5

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Acta Ortop Mex 2010; 24 (5)

Functional results of nervous reconstruction in an upper limb. Report of a multicentric trial

Herrera-Tenorio JG, Chávez-Galván CR, Sesma-Villalpando RA, Farías-Castañeda RE, Núñez-Fernández AI

Language: Spanish
References: 38
Page: 291-297
PDF size: 554.20 Kb.


ABSTRACT

Objective: To assess the functional results of nerve reconstruction with autologous interfascicular nerve grafts in a thoracic limb. Material and methods: From January 1999 to December 2006. Complete nerve injuries of the radial, median and ulnar nerves. Follow-up was at least 12 months. Variables: age, nerve defect length, location, interval between the injury and the treatment, mechanism, injuries, and adjunctive treatments. The procedures were performed by the authors. Nine and 10-0 sutures were used. The Medical Research Council System (MRCS) scale was used for the functional measurement. The χ2 test was applied to variables and functional results. Results: 43 patients, 48 nerves, mean age 26.7 years; 29 males and 14 females. Nineteen injuries occurred in the ulnar nerve (39.5%), 18 in the median nerve (37.5%) and 11 in the radial nerve (23%). Five patients had injury of the median and ulnar nerves. Twenty three injuries involved the wrist (53.4%), 7 the forearm (16.2%) and 12 the arm (27.9%). The mean time elapsed between the injury and the treatment was 42.09 days. The mean size of the nerve defect was 4.4 cm. The mean follow-up was 17.5 months. Forty two patients had associated injuries and 37 received adjunctive treatment. Motor function: Results were good in 15 patients (31.2%), fair in 21 (43.8%), poor in 10 (20.8%) and bad in 2 (4.2%). Sensory function: Results were good in 36 nerves (75%), fair in 4 (8.3%), poor in 6 (12.5%) and bad in 2 (4.2%). Discussion: The results were similar to those reported in the literature. Conclusions: Good results were obtained in gaps ≤ 5 cm, in cases without arterial injury and when the time to treatment did not exceed 40 days (p ‹ 0.05). The age, the nerve and the site of injury were not influencing factors.


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