淺橈神經斷裂的治療－四例病例報告－

在手部的感覺神經中，淺橈神經位於最表層，無論是意外受傷或是手術過程中均很容易傷害到淺橈神經，雖然它只是感覺神經，與手部的運動功能無關。但由於其解剖位置相當表淺，直接位於骨頭上，又缺乏柔軟組織的保護，它一旦斷裂後所產生的神經瘤很容易受到刺激，引起厲害的則痛及麻木感，同時手部之其他部位亦產生不正常的麻感，影響手部的功能。R. W. Beasley 發現淺橈神經斷裂後，在未端部分產生感覺異常的神經衝動係經由後骨間神經而傳到中樞，所以在治療淺橈神經的神經瘤時須同時作後骨間神經末端截斷術才能治療這種感覺異常的現象。我們提出四例淺橈神經瘤的治療心得，以印證這個理論。

關鍵字

淺橈神經；神經瘤；神經截斷術

並列摘要

Among the sensory nerves of the hand, the sensory branch of the radial nerve lies at the most superficial layer. It lies over very hard substance, bone and ligament. It is easily hurt in the daily activities or on the surgical procedures. Owing to the lack of soft tissue protection, the injured nerve is easily irritated and results in symptomatic neuroma. The neuroma of sensory branch of radial nerve has a characteristic symptom--dysesthesia over the distal dermatome of sensory branch of radial nerve. It disables the hand and is difficult to be treated. Lluch and Beasley found that the dysesthetic impulse is transmitted throngh the posterior interosseous nerve. In order to get complete treatment of painful neuroma of sensory branch of radial nerve, neurectomy of the terminal branch of posterior interosseous nerve must be performed. We presented 4 cases of sensory branch of radial nerve injury. Two of them were treated with neurectomy of posterior interosseous nerve and they got immediate improvement of hand function after operation. So, we concluded that the goal of treatment should be emphasizing the importance of rapidly restoring hand function but not restoring the sensation at the dermatome of sensory branch of radial nerve.

並列關鍵字

superficial Radial Nerve ； neuroma ； neurectomy

國際替代計量

淺橈神經斷裂的治療－四例病例報告－

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