Ballistic peripheral nerve injuries: basic concepts, controversies, and proposal for a management strategy

Mathieu, Laurent; Goncalves, Melody; Murison, James Charles; Pfister, Georges; Oberlin, C.; Belkheyar, Zoubir

doi:10.1007/s00068-022-01929-8

Cited by 9 publications

(2 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…У разі закритого перелому в ділянці дистальних метаепіфізів плечової або стегнової кісток зміщені кісткові уламки можуть здавлювати судини та нерви, що супроводжується значним розтягненням їх у довжину. Також описано випадки травми нерва з його розтягненням у разі вог непальних поранень або мінно-вибу хових травм [50]. У разі вогнепального ушкодження під час проходження кулі крізь тканини ПН може травмуватися внаслідок прямої механічної дії, ударних хвиль та утворення тимчасової порожнини, що пульсує.…”

Section: тракційна травма периферичного нерваunclassified

Peripheral nerve traction injury. Literature review

Tsymbaliuk,

Vorodi,

Petriv

et al. 2023

Ukr Neurosurg J

View full text Add to dashboard Cite

Traction injury of the peripheral nerve (TIPN) is an injury that occurs as a result of stretching the nerve beyond its normal elastic properties. An analysis of the available literature has revealed the following. TIPN is the most common type of severe nerve injury in the setting of road traffic accidents, catatrauma, gunshot wounds, birth injuries, etc. The dynamics of TIPN during fast and slow stretching is the same and includes three phases: elastic, inelastic and tearing. The limits of elastic stretching of the nerve are determined by the degree of tortuosity of myelinated fibers and the elasticity of the connective tissue framework of the nerve. Stretching of the nerve beyond its elastic limits is characterized by rupture of axons and endoneurial sheaths, including at a considerable distance from the epicenter of pathomorphological changes, which determines the severity of the injury and the impossibility of effective nerve autoregeneration. The force of stretching and the direction of its application to the nerve trunk determine the severity of TIPN. The degree of nerve stretching varies along its length and reaches a maximum in the periarticular areas. A fairly moderate stretching of the nerve can lead to a noticeable change in the conductivity of electrical impulses. Unlike other localized types of nerve injury, the pattern of pathomorphological changes in TIPN includes various forms of damage to structural elements. Understanding the pathophysiology of TIPN is a prerequisite for the development of optimal treatment of this type of injury.

show abstract

Section: тракційна травма периферичного нерваunclassified

Peripheral nerve traction injury. Literature review

Tsymbaliuk,

Vorodi,

Petriv

et al. 2023

Ukr Neurosurg J

View full text Add to dashboard Cite

show abstract

“…With improvements in our understanding of nerve injuries, there have been challenges to historical precedent. Earlier surgical exploration in the setting of sensory or motor deficits has been advocated, citing that early surgical exploration may allow for a clear diagnosis at the time of injury that can be invaluable in informing concurrent or future repair options 14,15 .…”

mentioning

confidence: 99%

Upper Extremity Ballistic Nerve Injury

Wolf,

Chen,

Strelzow

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

» Gunshot injuries to the upper extremity (UE) have high likelihood for causing peripheral nerve injury secondary to the high density of vital structures. Roughly one-fourth of patients sustaining a gunshot wound (GSW) to the UE incur a nerve injury. Of these nerve injuries, just over half are neurapraxic. In cases of surgical exploration of UE nerve injuries, nearly one-third demonstrate a transected or discontinuous nerve.» Existing literature regarding surgical management of nerve injuries secondary to GSWs comes from both military and civilian injuries. Outcomes are inconsistently reported, and indications are heterogeneous; however, reasonable results can be obtained with nerve reconstruction.» Our proposed management algorithm hinges on 4 treatment questions: if there is a nerve deficit present on examination, if there is a concomitant injury in the extremity (i.e., fracture or vascular insult), whether the injured nerve would be in the operative field of the concomitant injury, and whether there was an identified nerve lesion encountered at the time of surgery by another surgeon?» Early exploration rather than continued expectant management may offer improved recovery from GSW nerve injuries in particular situations. When an UE nerve deficit is present, establishing follow-up after the initial GSW encounter and early referral to a peripheral nerve surgeon are pivotal.

show abstract

Traumatic Sciatic Nerve Lesions

Akhaddar

2023

Atlas of Sciatica

View full text Add to dashboard Cite

Ballistic peripheral nerve injuries: basic concepts, controversies, and proposal for a management strategy

Cited by 9 publications

References 57 publications

Peripheral nerve traction injury. Literature review

Peripheral nerve traction injury. Literature review

Upper Extremity Ballistic Nerve Injury

Traumatic Sciatic Nerve Lesions

Contact Info

Product

Resources

About