Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LI Qichao , LIU Zhangmin , LU Junyue , SHAO Wenchai , FENG Xiaobo

Department of Hand Surgery, Renqiu City People’s Hospital, Renqiu Hebei, 062550, P.R.China;

Corresponding author：

LI Qichao, Email: liqichaoqxj@126.com

Keywords：

Nerve transfer; proper digital nerve; nerve avulsion; thumb injury

DOI：

10.7507/1002-1892.201612105

Video：

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Objective To investigate the effectiveness of transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion. Methods Between January 2007 and May 2015, 23 patients with thumb nerve avulsion were treated by transferring the ulnaris proper digital nerve of index finger and its dorsal branch. There were 17 males and 6 females with an average age of 32 years (range, 16-63 years). The injuries were caused by machine twist in 10 cases, electric saw in 8 cases, and sharp article prick in 5 cases. And thumb rotational avulsion amputation happened in 8 cases, thumb incomplete amputation in 2 cases, laceration of thumb palmaris with the thumb nerve avulsion of both sides in 13 caese (7 cases with tendon rupture). The time from injury to operation was 1.0-3.5 hours (mean, 2.2 hours). Results All incisions healed by first intention. Ten cases of thumb reimplantation were successful. All the patients were followed up for 5 months to 2 years and 8 months, with an average of 1 year and 4 months. Two-point discrimination was 3-9 mm (mean, 6.8 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the sensory of the thumb was rated as S₄ in 18 cases and in 5 cases; the sensory at donor sites recovered to S₃. Conclusion Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.

Citation： LI Qichao, LIU Zhangmin, LU Junyue, SHAO Wenchai, FENG Xiaobo. Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 992-995. doi: 10.7507/1002-1892.201612105 Copy

1.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
2.	顾玉东, 王澍寰, 侍德. 手外科手术学. 2 版. 上海: 复旦大学出版社, 2010: 206-215.
3.	陈政, 许亚军, 寿奎水, 等. 近节指背逆行岛状皮瓣修复手指皮肤缺损. 中华手外科杂志, 2010, 26(1): 1-3.
4.	王澍寰. 手外科学. 3 版. 北京: 人民卫生出版社, 2014: 324-325, 328-329, 522-523.
5.	张文龙, 高顺红, 刘会仁, 等. 拇指旋转撕脱性离断的改良再植. 中华显微外科杂志, 2010, 33(5): 433.
6.	杨延军, 张子清, 刘良燚, 等. 前臂掌测浅静脉在拇指旋转撕脱离断再植中的应用. 中华显微外科杂志, 2010, 33(3): 240-242.
7.	赵晓航, 胡德锋, 叶红禹, 等. 保留掌指关节的拇指旋转撕脱性离断再植. 中华显微外科杂志, 2011, 34(4): 343-344.
8.	刘光军, 谭琪, 王成琪, 等. 臂外侧皮瓣在复杂性拇指离断再植中的应用. 中华手外科杂志, 2011, 27(5): 281-282.
9.	张全荣, 芮永军, 孙振中, 等. 拇指骨与皮肤软组织缺损的显微外科治疗. 中华手外科杂志, 2013, 36(3): 277-278.
10.	杨国涛, 陈建红, 李云龙, 等. 三种神经吻合方法修复双侧指固有神经缺损的比较研究. 中华骨科杂志, 2014, 34(10): 1037-1041.
11.	马瑞峰, 孙鹏. 不同吻合方式修复双侧指固有神经缺损疗效比较. 临床骨科杂志, 2016, 19(1): 68-71.
12.	吴柯, 张全荣, 强力, 等. 示指指背神经转位术在拇指撕脱性离断再植中的应用. 中华显微外科杂志, 2016, 39(5): 494-495.
13.	李启朝, 张双喜, 朱广明, 等. 拇小指指背神经移位修复指固有神经. 中华创伤骨科杂志, 2011, 13(4): 388-389.
14.	李启朝, 张双喜, 陈振喜, 等. 指固有神经背侧支移位重建指腹感觉功能. 中华手外科杂志, 2011, 27(1): 33-34.
15.	李启朝, 彭永利, 张双喜, 等. 拇指撕脱离断伤再植术中两侧指固有神经的修复. 实用手外科杂志, 2010, 24(1): 40-41.
16.	张宁, 宿晓雷, 陈广先, 等. 多种方法重建旋转撕脱离断拇指感觉的对比研究.中华手外科杂志, 2016, 32(2): 159.
17.	庞水发, 常湘珍, 张方晨, 等. 皮瓣移植临床应用应坚持原则. 中华显微外科杂志, 2010, 33(1): 1-2.
18.	Muyldermans T, Hiemer R. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr, 2009, 4(1): 27-33.

1. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
2. 顾玉东, 王澍寰, 侍德. 手外科手术学. 2 版. 上海: 复旦大学出版社, 2010: 206-215.
3. 陈政, 许亚军, 寿奎水, 等. 近节指背逆行岛状皮瓣修复手指皮肤缺损. 中华手外科杂志, 2010, 26(1): 1-3.
4. 王澍寰. 手外科学. 3 版. 北京: 人民卫生出版社, 2014: 324-325, 328-329, 522-523.
5. 张文龙, 高顺红, 刘会仁, 等. 拇指旋转撕脱性离断的改良再植. 中华显微外科杂志, 2010, 33(5): 433.
6. 杨延军, 张子清, 刘良燚, 等. 前臂掌测浅静脉在拇指旋转撕脱离断再植中的应用. 中华显微外科杂志, 2010, 33(3): 240-242.
7. 赵晓航, 胡德锋, 叶红禹, 等. 保留掌指关节的拇指旋转撕脱性离断再植. 中华显微外科杂志, 2011, 34(4): 343-344.
8. 刘光军, 谭琪, 王成琪, 等. 臂外侧皮瓣在复杂性拇指离断再植中的应用. 中华手外科杂志, 2011, 27(5): 281-282.
9. 张全荣, 芮永军, 孙振中, 等. 拇指骨与皮肤软组织缺损的显微外科治疗. 中华手外科杂志, 2013, 36(3): 277-278.
10. 杨国涛, 陈建红, 李云龙, 等. 三种神经吻合方法修复双侧指固有神经缺损的比较研究. 中华骨科杂志, 2014, 34(10): 1037-1041.
11. 马瑞峰, 孙鹏. 不同吻合方式修复双侧指固有神经缺损疗效比较. 临床骨科杂志, 2016, 19(1): 68-71.
12. 吴柯, 张全荣, 强力, 等. 示指指背神经转位术在拇指撕脱性离断再植中的应用. 中华显微外科杂志, 2016, 39(5): 494-495.
13. 李启朝, 张双喜, 朱广明, 等. 拇小指指背神经移位修复指固有神经. 中华创伤骨科杂志, 2011, 13(4): 388-389.
14. 李启朝, 张双喜, 陈振喜, 等. 指固有神经背侧支移位重建指腹感觉功能. 中华手外科杂志, 2011, 27(1): 33-34.
15. 李启朝, 彭永利, 张双喜, 等. 拇指撕脱离断伤再植术中两侧指固有神经的修复. 实用手外科杂志, 2010, 24(1): 40-41.
16. 张宁, 宿晓雷, 陈广先, 等. 多种方法重建旋转撕脱离断拇指感觉的对比研究.中华手外科杂志, 2016, 32(2): 159.
17. 庞水发, 常湘珍, 张方晨, 等. 皮瓣移植临床应用应坚持原则. 中华显微外科杂志, 2010, 33(1): 1-2.
18. Muyldermans T, Hiemer R. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr, 2009, 4(1): 27-33.

Chinese Journal of Reparative and Reconstructive Surgery

Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion

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