ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ ĐỨT THẦN KINH GIỮA VÙNG 1/3 DƯỚI CẲNG TAY VÀ CỔ TAY BẰNG KHÂU NỐI VI PHẪU TẠI CẦN THƠ NĂM 2025-2026

Abstract

Background: Median nerve laceration at the distal third of the forearm and wrist represents a common peripheral nerve injury of the upper extremity, resulting in impaired fine motor function, diminished grip strength, and sensory disturbance over the palmar surface of the hand. Without timely intervention, patients are at risk of thenar muscle atrophy and permanent functional deficit of the hand. Microsurgical repair is currently regarded as the gold standard treatment; however, studies addressing this condition in the Mekong Delta region remain limited. Objectives: To describe the clinical characteristics and evaluate the functional outcomes of microsurgical median nerve repair in patients presenting with median nerve transection at the distal forearm and wrist. Materials and methods: A descriptive case series study was conducted on 30 patients who underwent surgical intervention at the Department of Orthopedics and Traumatology, Can Tho Central General Hospital. Results: Male patients predominated, accounting for 26 of 30 cases, with a mean age of 36.8 years ± 2.65 (range: 8–65 years). The most common mechanism of injury was laceration by broken glass (66.7%). All patients sustained concomitant tendon injuries; vascular bundle injuries were identified in 50% of cases, and associated ulnar nerve injury was observed in 30%. All patients underwent microsurgical repair within 72 hours of injury. The mean follow-up duration was 8.5 months. Functional recovery was rated as good or above in 93.3% of cases. Conclusion: Median nerve transection at the forearm and wrist predominantly affects males of working age, most commonly caused by sharp object lacerations and frequently associated with tendon and vascular injuries. Early microsurgical intervention yields favorable functional outcomes, particularly in younger patients and those with fewer concomitant injuries.