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      Estudo prospectivo da sensibilidade tátil em mãos de uma população brasileira usando pressure-specified sensory device Translated title: Prospective study on tactile sensitivity in the hands of a brazilian population using the pressure-specified sensory device

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          Abstract

          OBJETIVO: Avaliar os limiares de percepção da pressão em polpas de dois dedos (indicador e mínimo), em uma população brasileira, sem lesão nervosa ou neuropatia. MÉTODOS: Usamos Pressure-Specified Sensory Device, um equipamento computadorizado para obter limiares de percepção da pressão normal, tanto estáticos quanto dinâmicos, e discriminação de dois pontos. RESULTADOS: Testamos a sensibilidade nos dedos, em 30 voluntários. Os testes de significância foram realizados utilizando o teste t de Student. Os valores médios (g/mm²) para os limiares de pressão estática de um e dois pontos (s1PD, s2PD) e discriminação dinâmica de um e dois pontos (m1PD, m2PD) no dedo indicador dominante foram: s1PD = 0,4, m1PD = 0,4, s2PD = 0,48, m2PD = 0,51. CONCLUSÃO: Não há diferença significativa na sensibilidade entre as mãos dominante e não dominante.

          Translated abstract

          OBJECTIVE: To evaluate the pressure perception thresholds on the pulp of two fingers (index and little fingers), among a Brazilian population with no nerve injury or neuropathy. METHODS: We used the Pressure-Specified Sensory Device (a computerized device) to derive static and dynamic normal pressure perception thresholds and two-point discrimination distances. RESULTS: We tested finger sensitivity on 30 volunteers. Significance analyses were performed using the Student t test. The mean values (g/mm²) for static one and two-point pressure thresholds (s1PD, s2PD) and dynamic one and two-point discrimination (m1PD, m2PD) in the dominant index finger were: s1PD = 0.4, m1PD = 0.4, s2PD = 0.48, m2PD = 0.51. CONCLUSION: There was no significant difference in sensitivity between the dominant and nondominant hands.

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          Normative vibrotactile thresholds measured at five European test centres.

          To compare vibrotactile thresholds between five international test centres, to determine causes of variability, and to provide normative data for use by health professionals. Vibrotactile thresholds were measured on various fingers in 1,008 subjects at 31.5 Hz (2,531 measurements) and at 125 Hz (2,807 measurements). Three centres used the up-and-down method of limits, rate of change of stimulus 3dB/s, to obtain vibrotactile thresholds. The push force on the surround was 2 N, the probe contact force was 1 N and the probe diameter was 6 mm concentric to a 10-mm diameter hole in the surround. One centre used an up-and-down method of limits with a 5-dB step and a 1.26-mm diameter probe with no surround. Another centre used a stepping algorithm, no surround, and the force on the 6-mm-diameter probe was unspecified. The 31.5-Hz thresholds and 125-Hz thresholds, expressed in dB, were similar between centres using similar methods. There were small (<5 dB) differences in vibrotactile thresholds between male and female subjects, between white-collar and blue-collar workers and between fingers. Both 31.5-Hz and 125-Hz thresholds increased with age; the mean effect of age on 31.5-Hz thresholds was approximately 2 dB over 25 years, while the effect of age on 125 Hz-thresholds was as high as 10 dB over 25 years. Vibrotactile thresholds are influenced by measurement method but can be similar at different centres if similar methods are used. Effects of measurement location and gender are often negligible. Thresholds depend on age, but over the range of ages considered, only the effect on 125-Hz thresholds is sufficient for correction; methods of correcting for age are given. These normative data may be used to assist the diagnosis of peripheral neuropathy involving vibrotactile sensation.
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            Crossover innervation after digital nerve injury: myth or reality?

            Several clinical studies promulgate the concept that some degree of crossover innervation occurs after digital nerve injuries are sustained and that the intact digital nerve might even substitute for the loss of nerve function on the injured side. Other studies strongly dispute the existence of this phenomenon. An excellent model for evaluation of crossover innervation is bilateral sharp digital nerve lacerations because there is no confusion of anomalous innervation from an intact contralateral nerve. This model avoids problems seen with replanted digits such as the inherent ischemia, multistructural injury, and the frequent crush component. The author evaluates the role of crossover innervation after digital nerve injury by comparing recovery of sensibility after unilateral and bilateral epineural neurorrhaphies. A retrospective review of 74 sharp unilateral and bilateral epineural digital nerve repairs in 54 patients using microsurgical techniques was performed by measurement of Weber's two-point discrimination (2PD). Fifty-four unilateral digital nerve repairs were performed in 46 patients who ranged in age from 8 to 54 years (mean age, 30.8 years). Concomitant flexor tendon injuries occurred in 50% of patients. Injury to repair was less than 1 day in 14.3% of patients, 2 to 7 days in 34.7%, 8 to 30 days in 40.8%, and 31 to 300 days in 10.2%. Follow-up ranged from 6 to 68 months (average follow-up, 13.8 months). Twenty bilateral digital nerve repairs were performed in 8 patients who ranged in age from 6 to 37 years (mean age, 27.6 years). Concomitant flexor tendon injuries occurred in 80% of patients. Injury to repair was less than 1 day in 10% of patients, 2 to 7 days in 60%, 8 to 30 days in 20%, and 31 to 300 days in 10%. Follow-up ranged from 6 to 77 months (average follow-up, 15.8 months). In this series, 2PD averaged 7.8 mm after unilateral digital nerve repairs compared with 7.1 mm after bilateral nerve repairs. Recovery of sensibility was also stratified into groups according to modified American Society for Surgery of the Hand guidelines: excellent, 15 mm or protective sensation. Unilateral digital nerve repairs produced excellent results in 27.8% of patients, good in 46.3%, and fair in 25.9% compared with bilateral nerve repairs with excellent results in 15% of patients, good in 70%, and fair in 15%. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Crossover innervation did not appear to influence the long-term outcome after digital neurorrhaphy.
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              Silver staining of nerve endings in human digital glabrous skin.

              A Ridley (1969)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbort
                Revista Brasileira de Ortopedia
                Rev. bras. ortop.
                Sociedade Brasileira de Ortopedia e Traumatologia (São Paulo )
                1982-4378
                2012
                : 47
                : 3
                : 344-347
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S0102-36162012000300011
                10.1590/S0102-36162012000300011
                c125cb11-8381-49bd-b524-fb82dd1d6573

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0102-3616&lng=en
                Categories
                ORTHOPEDICS

                Orthopedics
                Touch Perception,Median Neuropathy,Ulnar Neuropathies,Percepção Tátil,Neuropatia Mediana,Neuropatias Ulnares

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