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.	潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
2.	顧玉東, 王澍寰, 侍德. 手外科手術學. 2 版. 上海: 復旦大學出版社, 2010: 206-215.
3.	陳政, 許亞軍, 壽奎水, 等. 近節指背逆行島狀皮瓣修復手指皮膚缺損. 中華手外科雜志, 2010, 26(1): 1-3.
4.	王澍寰. 手外科學. 3 版. 北京: 人民衛生出版社, 2014: 324-325, 328-329, 522-523.
5.	張文龍, 高順紅, 劉會仁, 等. 拇指旋轉撕脫性離斷的改良再植. 中華顯微外科雜志, 2010, 33(5): 433.
6.	楊延軍, 張子清, 劉良燚, 等. 前臂掌測淺靜脈在拇指旋轉撕脫離斷再植中的應用. 中華顯微外科雜志, 2010, 33(3): 240-242.
7.	趙曉航, 胡德鋒, 葉紅禹, 等. 保留掌指關節的拇指旋轉撕脫性離斷再植. 中華顯微外科雜志, 2011, 34(4): 343-344.
8.	劉光軍, 譚琪, 王成琪, 等. 臂外側皮瓣在復雜性拇指離斷再植中的應用. 中華手外科雜志, 2011, 27(5): 281-282.
9.	張全榮, 芮永軍, 孫振中, 等. 拇指骨與皮膚軟組織缺損的顯微外科治療. 中華手外科雜志, 2013, 36(3): 277-278.
10.	楊國濤, 陳建紅, 李云龍, 等. 三種神經吻合方法修復雙側指固有神經缺損的比較研究. 中華骨科雜志, 2014, 34(10): 1037-1041.
11.	馬瑞峰, 孫鵬. 不同吻合方式修復雙側指固有神經缺損療效比較. 臨床骨科雜志, 2016, 19(1): 68-71.
12.	吳柯, 張全榮, 強力, 等. 示指指背神經轉位術在拇指撕脫性離斷再植中的應用. 中華顯微外科雜志, 2016, 39(5): 494-495.
13.	李啟朝, 張雙喜, 朱廣明, 等. 拇小指指背神經移位修復指固有神經. 中華創傷骨科雜志, 2011, 13(4): 388-389.
14.	李啟朝, 張雙喜, 陳振喜, 等. 指固有神經背側支移位重建指腹感覺功能. 中華手外科雜志, 2011, 27(1): 33-34.
15.	李啟朝, 彭永利, 張雙喜, 等. 拇指撕脫離斷傷再植術中兩側指固有神經的修復. 實用手外科雜志, 2010, 24(1): 40-41.
16.	張寧, 宿曉雷, 陳廣先, 等. 多種方法重建旋轉撕脫離斷拇指感覺的對比研究.中華手外科雜志, 2016, 32(2): 159.
17.	龐水發, 常湘珍, 張方晨, 等. 皮瓣移植臨床應用應堅持原則. 中華顯微外科雜志, 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. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
2. 顧玉東, 王澍寰, 侍德. 手外科手術學. 2 版. 上海: 復旦大學出版社, 2010: 206-215.
3. 陳政, 許亞軍, 壽奎水, 等. 近節指背逆行島狀皮瓣修復手指皮膚缺損. 中華手外科雜志, 2010, 26(1): 1-3.
4. 王澍寰. 手外科學. 3 版. 北京: 人民衛生出版社, 2014: 324-325, 328-329, 522-523.
5. 張文龍, 高順紅, 劉會仁, 等. 拇指旋轉撕脫性離斷的改良再植. 中華顯微外科雜志, 2010, 33(5): 433.
6. 楊延軍, 張子清, 劉良燚, 等. 前臂掌測淺靜脈在拇指旋轉撕脫離斷再植中的應用. 中華顯微外科雜志, 2010, 33(3): 240-242.
7. 趙曉航, 胡德鋒, 葉紅禹, 等. 保留掌指關節的拇指旋轉撕脫性離斷再植. 中華顯微外科雜志, 2011, 34(4): 343-344.
8. 劉光軍, 譚琪, 王成琪, 等. 臂外側皮瓣在復雜性拇指離斷再植中的應用. 中華手外科雜志, 2011, 27(5): 281-282.
9. 張全榮, 芮永軍, 孫振中, 等. 拇指骨與皮膚軟組織缺損的顯微外科治療. 中華手外科雜志, 2013, 36(3): 277-278.
10. 楊國濤, 陳建紅, 李云龍, 等. 三種神經吻合方法修復雙側指固有神經缺損的比較研究. 中華骨科雜志, 2014, 34(10): 1037-1041.
11. 馬瑞峰, 孫鵬. 不同吻合方式修復雙側指固有神經缺損療效比較. 臨床骨科雜志, 2016, 19(1): 68-71.
12. 吳柯, 張全榮, 強力, 等. 示指指背神經轉位術在拇指撕脫性離斷再植中的應用. 中華顯微外科雜志, 2016, 39(5): 494-495.
13. 李啟朝, 張雙喜, 朱廣明, 等. 拇小指指背神經移位修復指固有神經. 中華創傷骨科雜志, 2011, 13(4): 388-389.
14. 李啟朝, 張雙喜, 陳振喜, 等. 指固有神經背側支移位重建指腹感覺功能. 中華手外科雜志, 2011, 27(1): 33-34.
15. 李啟朝, 彭永利, 張雙喜, 等. 拇指撕脫離斷傷再植術中兩側指固有神經的修復. 實用手外科雜志, 2010, 24(1): 40-41.
16. 張寧, 宿曉雷, 陳廣先, 等. 多種方法重建旋轉撕脫離斷拇指感覺的對比研究.中華手外科雜志, 2016, 32(2): 159.
17. 龐水發, 常湘珍, 張方晨, 等. 皮瓣移植臨床應用應堅持原則. 中華顯微外科雜志, 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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