Two-point discrimination tests versus functional sensory recovery in both median and ulnar nerve complete transections.
Transection of both median and ulnar nerves provides an objective model to compare sensory and functional recovery. 22 patients were evaluated after nerve repair. The mean age was 30 years and the mean time since surgery 80 months. Primary direct suture was performed in 15 patients and six grafts were necessary. Median nerve suture and ulnar nerve graft were combined in one case. Both sensory and functional evaluation were completed. Statistical evaluation analyzed the relationship between age, injury location, mechanism, type of rehabilitation and the result, and the relationship between two-point discrimination distance (2-PD) and the functional score. According to the S0 to S4 grading, only 26.5% (ulnar) and 31% (median) of direct suture cases achieved S3+ or more. All nerve grafts in adults were poor. A strong relationship was found between two-point discrimination distance (moving and static) and the functional result, even after multivariate analysis. A modification of the Medical Research Council's classification is suggested.
Chassard
M
M
Department of Hand Surgery, Hôpital E. Herriot, Centre d'Informatique Médicale Alexis Carrel, Lyon, France.
Pham
E
E
Comtet
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D004192:Discrimination, Psychological; D005260:Female; D006225:Hand / Q000294:innervation*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries*; D008875:Middle Aged; D012677:Sensation / Q000502:physiology*; D013997:Time Factors; D014110:Touch / Q000502:physiology; D014459:Ulnar Nerve / Q000293:injuries*; D014947:Wounds and Injuries / Q000534:rehabilitation