Diagnostics and Treatment of Proximal Tunnel Neuropathies of the Upper Limbs

Третьякова, А. И.; Коваленко, Ю. В.; Tretiakov, R.A.; Tsymbaliuk, Yu.V.; Chebotariova, Lidiya; Gatskiy, Alexander A.; Tsymbaliuk, Ya.V.; Tretyak, Ihor B.

doi:10.18484/2305-0047.2020.1.62

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“…The availability of modern equipment and means of microsurgical treatment also has a significant impact on the results of surgical treatment, as well as the level of doctor's training skills. While the use of microsurgery techniques in the surgical treatment of peripheral nerve damage (including gunshot) is widely represented in the literature [14,15], the use of long-term epineural electrical stimulation to restore nerve function is represented mainly by experimental work [16][17][18][19]. Our experience with the use of implantable neurostimulators in clinical practice to restore nerve function after its decompression indicates the prospects of long-term epineural electrical stimulation in the treatment of combat trauma to peripheral nerves.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Peripheral Nerves Combat Wounds of the Extremities

et al. 2021

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The aim: Improving the effectiveness of patients' treatment with combat injuries of the peripheral nervous system, which consists in the application and development of new methods of reconstructive interventions, optimizing a set of therapeutic and diagnostic measures for the most effective management of this category of patients with peripheral nerve injury. Materials and methods: The research is based on the results of surgical treatment of 138 patients with combat injuries of peripheral nerves for the period from 2014 to 2020. The mean age was 33.5 ± 2.1 years. Patients were treated for 1 to 11 months after injury (median – 8 months). Damage to the sciatic nerve was observed in 26.1%, ulnar – in 20.3%, median – in 18.8%, radial – in 15.9%, tibial – in 10.9%, common peroneal nerve – in 8% of cases. Results: It was shown that in all patients was significantly improved the recovery of all nerves. In the period from 9 to 12 months, the degree of recovery of motor function to M0-M2 was observed in 40.6%, to M3 – in 35.5%, to M4 – in 16.7%, to M5 – in 7,2%. The degree of recovery of sensitivity to S0-S2 was observed in 36.2%, to S3 – in 42.8%, to S4 – in 17.4%, to S5 – in 3.6%. Regression of pain syndrome after surgery was observed in 81.2% of patients. Conclusions: The results of surgical treatment of peripheral nerves gunshot injury are generally worse than other types of nerve injuries. The best results of surgical treatment of combat trauma of peripheral nerves are obtained in patients with sciatic nerve damage.

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