正中神経および尺骨神経損傷の予後に対する臨床的研究

By direct examinations of 46 patients with 55 injured nerves out of those patients who had received the suture of injured median and ulnar nerves in the past 7 years at Department of Orthoedic Surgery, Okayama University and of those over one year after the operation, postoperative results were studied and the following findings were obtained. 1. As the lapse of time after inception of the nerve injnry passes 3 months, the postoperative result gradually grows poorer and after 6 months the prognosis is extremely poor. In contrast, the secondary suture performed as early as 3 to 8 weeks after the injury gives satisfactory results and it does not necessarily require primary suture. 2. The younger the patient, the better is the prognosis, especially the prognosis is very good in the age range of 0 to 9 years old. 3. It has been found that prognosis is relatively good in the cases of sharp cut injuries such as glass cut injury because the damage to nerves as well as to surrounding tissues is smaller and the danger of infection is less. 4. In the cases who had infection of some kind prior to receiving the nerve injury the postoperative results are invariably poor. 5. when the injury is sustained at a level more proximal, the results are poorer. Ulnar nerves are injured more frequently at high and intermediate levels. This point also explains the poor postoperative results in the cases of ulnar nerve injuries. 6. There is a possibility of recovery for the period of 5 years after the nerve suture, and especially the recovery of sensory function can be expected for 5 year period after the suture operation. 7. In the ease where median and ulnar nerves are injured simutaneously on the same level, these two nerves recover to about the same degree. 8. By means of two test, namely, picking up test and precision grip test, it has been possible to examine the effect on the routine affairs of life of the patient, that was ditficult to accomplisd by the former sensory tests. 9. The sudomotor function after suture of injured nerve does not necessarily parallel with the recovery of sense, and in the cases past 3 years after suture the sudomotor function in practically every case has recovered to normal irrespective of the sensory function.