Objective: To evaluate and analyze the long-term results of all the operation mordalities practised at present of late hand function reconstruction in patients with severe electrical injury of the wrists.
Methods: Forty-seven cases with late electrical injury of the wrists were followed up and comprehensively analyzed in terms of the long-term results of morphological reconstruction and functional restoration.
Results: In addition to cutaneous tissue repair and functional training of the joints of the wrists, the flexor digitorum reconstruction with auto free tendon grafting gave a poor result (only 33.4% of the cases with function above medium level). In one case, the wrist function was rebuilt by compound plantaris tendon free flap with leg deep facia and posterior tibial artery, resulting in the restoration of thumb flexor function, with shorter treating time and less postoperative adhesion. Median and ulnar nerves were repaired with free auto nerve grafting with no obvious effects. Two cases were repaired by compound tissue grafting of sural nerve and deep facia carried by small saphenous veins with uncertain result. In another 3 cases, with the aid of retrograde evoked potential (REP), a proximal anastomosis of nerves was done with fairly good result.
Conclusion: Insufficient blood supply and scar formation were the major causes of poor results of the tendon and nerve grafting. It was recommended that the graft should carry sufficient blood supply to improve the blood supply of the recipient bed in order to improve the therapeutic effects. The selection of proximal nerve segment should include the functional examination.