수지 탈피창환부에 유경피부이식후 유리신경 이식술에 대한 임상적 고찰

Abstract

In degloving injury of the fingers, the digital sensory nerve as well as the digital artery are damaged together with the skin of the finger at the time of injury. After skin coverage, sensibility is very important to the function of the hand with good active motion in anesthetic or paresthetic digits which is refused to use those digits because of either the lack of sensation or painful paresthesias when the fingers are stimulated, and which is easy to be exposed to many of injuries, such as burns and traumas. From October 1982 to December 1989, the free sensory nerve grafts on 31 fingers(27 patients) were performed using segments of the sural nerve at the Department of Orthopedic Surgery, College of Medicine, Keimyung University, Daegu. The purpose of this paper is to present a large series of patients who had sensory impairment after skin coverage in degloved fingers and who received free sensory nerve grafts. We also studied the factors thst are known to affect the results of a digital nerve graft:the age of patient, the length of the graft, the time-interval from injury to grafting, and suture method. Clinical evaluation was performed using the author's scale corresponding to this study, which is modification of grading system described by the British Medical Research Council. The follow up studies for an average of 28 months(from 12 to 54 months) showed good result.