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At least 19 recordsLinked to original sources
PubMed1977

Microsurgical treatment of peripheral nerve injuries.

In the period from 1972 to 1976, 536 patients with injuries of the peripheral nerves were treated at the Neurosurgical University Clinic Lyublyana. The treatment was performed according to the principles of microsurgery. Preoperative and postoperative supervision included EMG, electroneurography and nerve conduction speed. Subdivision: N. facialis 6, plexus brachialis 78, n. radialis 58, n. medianus 189, n. ulnaris 212, n. ischiadicus 17, n. femoralis 3, n. tibialis 12, n. fibularis 37. On the plexus brachialis 50 funiculolyses and 28 raphies were carried out. Immobilisation for 10 days. The length of the transplants showed no negative influence. After-observation was necessary for three and more years, especially in case of plexus injuries. Complete restoration was only found in children. Sensitivity in 80% more than Seddon III, 17% III and 3% less than III. Motor function in 60% IV, 20% III, 12% II and 8% less than II.

Adult↗
PubMed1976

Peripheral nerve injuries in children.

Recovery after peripheral nerve injuries in children is more complete than in adults and is inversely related to the age of the patient. The prognosis for the return of sensation following laceration of the median, ulnar, or digital nerve depends upon recovery of two point discrimination (in millimeters approximately equal to the child's age) at the time of nerve repair. The better results in children probably reflect the greater adaptability of the immature central nervous system to the nerve injury. Operative exploration of an open wound when there is a potential for nerve injury in an uncooperative child is the only sure way of determining the status of the nerves. Primary repair of cleanly divided nerves in tidy wounds is advocated if it can be done competently. Secondary repair is indicated for avulsion injuries, gunshot wounds, crush injuries, and human or animal bites. Delicate, atraumatic technique and accurate repair of the divided nerve are stressed. The more exacting technique of funicular repair may yield better results. Interfascicular cable grafting is a new and useful alternative to extensive mobilization in closing nerve gaps. Nonoperative treatment of nerve injuries associated with closed fractures is advocated unless there are no signs of nerve regeneration in two to three months. Obstetrical brachial plexus injuries of the upper plexus carry a better prognosis than lower plexus or total plexus injury. Early range of motion exercises to prevent contractures are stressed. Maximal recovery takes place within two years. The acute nerve compression syndrome should be considered an emergency and may require surgical decompression if it is severe and if rapid return of function does not occur following reduction of the fracture.

Adolescent↗
PubMed1979

Two modes of cutaneous reinnervation following peripheral nerve injury.

The return of sensation to the foot following sciatic nerve crush injury was analyzed behaviorally and electrophysiologically in the rat. Functional recovery begins within four days. Its early phase is accounted for by expansion of the functional distribution of intact neighboring fibers of the saphenous n. It occurs even if the sciatic n. is ligated, and it disappears with section of the saphenous n. Accompanying this functional expansion we began to encounter in electrophysiological recordings from the saphenous n., fibers with unusually large receptive fields (RF's) extending onto the plantar surface of the foot, well beyond their limits in intact rats. All of the expanded RF's were high threshold mechanoreceptors. On about the twentieth day after crushing, the regenerating sciatic n. began to make a functional contribution. This was seen by return of sensation to zones not invaded by the saphenous n. and by the onset of sensation in rats in which the saphenous n. had previously been ligated. With return of the sciatic n. the expanded distribution of the saphenous n. went back to its original boundaries. Correspondingly, we could no longer find expanded saphenous n. RF's. We conclude that cutaneous reinnervation begins with the collateral expansion of high threshold afferents from intact neighboring nerves. This alien innervation is later replaced upon regeneration of the original nerve.

Animals↗
PubMed1978

[Peripheral nerve injuries complicating extracranial vascular surgery (author's transl)].

Peripheral nerve injuries may complicate extracranial vascular surgery. Pareses of the recurrent and hypoglossal nerves are clinically important. The nervus laryngeus superior, the ramus marginalis mandibulae of the facial nerve and the brachial plexus may be involved. Horner's syndrom indicating damage of sympathetic fibers may also appear. Lesions of the glossopharyngeal, vagus and phrenic nerves are rather seldom.

Brachial Plexus↗
PubMed1977

[Surgery of therapy-resistant pain due to peripheral nerve injury].

1. The forms of peripherally triggered or localized pains are differentiated: Local pain of a neuromatous character, propagated pain, sympathalgia, phantom pain, causalgia, and combined forms. 2. Surgical operations are performed locally, to the spinal cord, brain, and sympathicus, as well as by neurostimulation on all levels. 3. The areas of indication differ according to the localization of pain and its probable cause. 4. Serving the prevention of pain after peripheral nerve injuries are the particular topical treatment of a fresh injury, psychic guidance, specific aftercare and physiotherapy, elimination of pension payment problems, and optimum reintegration into normal working life]

Cordotomy↗
PubMed1978

Transcutaneous electrical nerve stimulation in chronic pain after peripheral nerve injury.

Transcutaneous electrical stimulation was tested in 24 patients with chronic pain following a peripheral nerve injury in an extremity, in 10 patients with a good effect. All of these 10 patients displayed signs of increased sympathetic activity in addition to hyperalgesia. Sympathetic block gave complete freedeom from pain. In 14 patients with the same symptomatology but without an increased or with only very slightly increased sympathetic activity, no or an insignificant effect was obtained. Sympathetic block did not relieve the pain in this group. Transcutaneous electrical stimulation should be tried as an alternative to sympathectomy in causalgia major or minor.

Adult↗