指神经关节支切断术治疗手指PIP创伤性关节炎疼痛的临床疗效  

Clinical effect of neurotomy of articular branch of the digital nerve on treatment of traumatic arthritis of the proximal interphalangeal joint

作　　者：金光哲[1] 巨积辉[1] 张广亮[1] 王凯[1] 唐林峰[1] 王强[1] JIN Guangzhe;JU Jihui;ZHANG Guangliang(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215000,China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215000

出　　处：《实用手外科杂志》2020年第3期278-280,307,共4页Journal of Practical Hand Surgery

基　　金：江苏省青年医学人才项目(编号:QNRC2016223);江苏省333高层次人才资助项目(编号:BRA2017068)。

摘　　要：目的探讨切断指神经关节支治疗PIP创伤性关节炎疼痛的手术效果。方法2017年1月-2019年6月,对7例PIP创伤性关节炎疼痛的患者行双侧指神经关节支切断术,术后即开始功能康复训练,术前、术后采用VAS疼痛评分标准及TAM评分标准进行评分,并对关节功能进行疗效评价。结果术后伤口均一期愈合,无感染,无血管神经损伤,术后疼痛症状迅速缓解,手指PIP活动度明显改善。随访时间6~24个月,根据VAS疼痛评分标准,7例术后疼痛均得到有效缓解,根据TAM评定标准,优3例,良3例,可1例,优良率85.7%,关节功能得到改善,复查X线片未见明显骨关节退行性改变。结论采用指神经关节支切断术可有效缓解PIP创伤性关节炎的疼痛症状,改善关节功能。Objective To investigate the operative effect of neurotomy of articular branch of the digital nerve on treatment of traumatic arthritis of the proximal interphalangeal joint.Methods From January 2017 to June 2019,7 patients with traumatic arthritis of the proximal interphalangeal joint were treated with neurotomy of articular branch of the bilateral digital nerve.Functional rehabilitation training was started immediately after surgery.VAS pain scoring criteria and TAM scoring criteria were used as the pain and joint function measurement before and after operation,respectively.Results All the wounds healed well without infection.No neurovascular injury occurred.Pain symptoms were relieved quickly after the operation.The motion of the proximal interphalangeal joint was obviously improved.The patients were followed up from 6 to 24 months.According to the VAS pain scoring criteria,pain symptom was effectively relieved in all 7 cases.According to the TAM scoring criteria,excellent was in 3 cases,good in 3 cases and fair in one case.The joint motion was improved.The follow-up X-ray results showed no obvious degenerative changes of bone and joint.Conclusion It is an effective method to relieve the pain symptoms of traumatic arthritis of the proximal interphalangeal joint by using the neurotomy of articular branch of the digital nerve.The motion of injured joint was also improved.

关 键 词：指神经关节支 近侧指间关节 创伤性关节炎 疼痛 

分 类 号：R658.2[医药卫生—外科学]