Use of nerve elongator to repair short-distance peripheral nerve defects: a prospective randomized study.

Repair techniques for short-distance peripheral nerve defects, including adjacent joint flexion to reduce the distance between the nerve stump defects, "nerve splint" suturing, and nerve sleeve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no significant difference in long-term neurological function recovery was detected between the two groups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was significantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study confirm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective.

[Analysis of clinical outcomes of carpal tunnel syndrome combined with cervical nerve root compression].

OBJECTIVE: To analyze the clinical curative effect of carpal tunnel syndrome (CTS) combined with cervical nerve root compression and to explore the differences between CTS combined with cervical nerve root compression and simple CTS in the clinical manifestations, diagnosis and treatment. METHODS: From February 2004 to October 2010, 93 cases (120 sides) were selected among the patients (21 males and 72 females) adopted to our department and primarily diagnosed as CTS, of whom 29 had cervical nerve root compression. Neurolysis of peripheral nerve was conducted in the 93 cases, and the mean follow-up period was 16 months. RESULTS: The results of the improvements of symptoms and signs after operation were evaluated by the British Medical Research Council (BMRC). According to the BMRC scores, we divided the patients into three stages: excellent, good and none. In the 93 patients, 29 were with visible nerve root compression in radiograph or magnetic resonance imaging, in whom the excellent rate was 86.21%, and the good rate 13.79%, meanwhile in the patients without nerve root compression, the excellent rate was 90.63% and the good rate 9.37%. CONCLUSION: In the case of CTS combined with cervical nerve root compression, our findings are as follows: Firstly, neurolysis of peripheral nerve has an accurate curative effect; Secondly, neurolysis of peripheral nerve may decline the symptoms of nerve root compression; Thirdly, patients with nerve root compression are obviously more common in men, therefore, we should pay attention to the double crash when it comes to the male patient.