Journals / Selçuk Tıp Dergisi / 2001 / Cilt: 17 - Sayı: 4
End-to-side neurorraphy as a salvage procedure for irrepairable nerve injuries: The results of three cases with review of the pertinent literature
- Journal
- Selçuk Tıp Dergisi
- Pages
- 257–261
- DOI
- —
Abstract
Purpose: After a few reports on end-to-side nerve repair at the beginning of this century, the technique was put aside until it has recently been reintroduced by Viterbo. We herein present the results of three cases treated by end-to-side median-to-ulnar neurorraphy. Methods: Three patients with median nerve defects between 15 and 22cm were treated by end-to-side nerve repair, through an epineurial window. The follow-up times were between 12 and 18 months. Sensory evaluation involved superficial touch, pin-prick, and two point discrimination tests. Motor evaluation was done by assessing the presence of opposition, and palpating the abductor pollicis brevis. Results: Sensory recovery was observed in all the patients, in the median nerve dermatome. In case-3 it was incomplete at the tips of his fingers. Motor recovery was absent, except in case-1, who could perform opposition before the operation, as well. Conclusions: End-to-side nerve repair is a viable alternative in cases with long gaps between the ends of the injured nerve.
Özet
Amaç: Uç-yan sinir anastomozu ile ilgili ilk çalismalar geçtigimiz yüzyilin basinda bildirilmis, ancak daha sonra bir kenara birakilan bu teknik, yakinlarda Viterbo ile tekrar gündeme kazandirilmistir. Bu çalismada, uç-yan sinir anastomozu yaptigimiz üç vakaya ait sonuçlari inceledik. Metod: Median sinir yaralanmasi nedeniyle 15-22 cm arasinda sinir kaybi olan üç hastaya epinöral pencere açilarak uç-yan sinir anastomozu yapildi. Takip süreleri 12 ve 18 ay arasinda idi. Duyu muayenesi için hafif dokunma, yüzeysel agri ve iki nokta ayirimi testleri kullanildi. Motor degerlendirme oppozisyona bakilarak ve abdüktör pollisis brevis kasi palpe edilerek yapildi. Bulgular: Tüm hastalarda median sinir dermatomunda duyu iyilesmesi oldugu gözlendi. Ancak, üçüncü vakada parmak uçlarinda tam degildi. Motor iyilesme hiçbir hastada olmadi. Oppozisyon yapabilen üçüncü vakada bu bulgu ameliyat öncesinde de vardi. Sonuç: Uç-yan sinir anastomozu, sinir dokusunda uzun kayiplarin oldugu vakalarda iyi bir alternatif tedavi yöntemi olabilir.