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目的：对８１例８４条儿童正中神经损伤进行回顾性研究，讨论其诊断和处理问题。方法：伤于腋部３条，上臂１０条，肘部３０条，前臂１４条，腕部２４条，掌部３条；完全离断５３条，部分断裂４条，挫伤或压迫变性２７条；开放伤５６条，闭合伤２８条。采用神经外膜对端吻合术５１条，自体神经移植术４条，神经外松解术１５条，因毁损未处理３条，骨折复位外固定观察１１条。结果：随访５０条，１～２８（平均７．８）年，优良率为８８％。结论：本组有１４例漏诊，为避免漏诊应详细问病史、反复检查。神经开放伤（火器伤等除外）应一期手术探查修复神经，骨折合并伤观察１～３个月，晚期神经伤也要力争手术修复神经。神经断裂以外膜缝合为主，神经受压或变性以神经外松解术为主，拇指对掌功能恢复不佳时用小指外展肌重建拇指对掌功能。
OBJECTIVE: To retrospectively study the median nerve injury in 81 children with 84 children and to discuss their diagnosis and treatment problems. Methods: 3 injured axils, 10 upper arms, 30 elbows, 14 forearms, 24 wrists and 3 palm; completely cut off 53, partially broken 4, contusion or pressure degeneration 27; 56 open wounds, closed wounds 28. There were 51 epineurium end-to-end anastomoses, 4 autologous nerve grafts, 15 extranodal lymphadenectomy, 3 untreated lesions and 11 external fixations. Results: The follow-up of 50, 1 ~ 28 (average 7.8) years, excellent and good rate was 88%. Conclusion: This group of 14 missed diagnosis, in order to avoid misdiagnosis should be detailed history, repeated examination. Open nerve injury (except for firearm injuries, etc.) should be a surgical exploration of nerve repair, fracture injury observed 1 to 3 months, advanced nerve injury should also strive to repair the nerve. Nerve rupture mainly by the outer membrane, nerve compression or degeneration to extranodal release-based, poor recovery of the thumb on the palm with the little finger abductor muscle reconstruction of the thumb on the palm function.