scholarly journals Current concepts in diagnosis and management of common upper limb nerve injuries in children

2021 ◽  
Vol 15 (2) ◽  
pp. 89-96
Author(s):  
Nunzio Catena ◽  
Giovanni Luigi Di Gennaro ◽  
Andrea Jester ◽  
Sergio Martínez-Alvarez ◽  
Eva Pontén ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Soft Tissues ◽  
Spontaneous Recovery ◽  
Paediatric Population ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Pain Anxiety ◽  
Open Questions ◽  
Open Injuries

Peripheral nerve injuries (PNI) of the upper limb are a common event in the paediatric population, following both fractures and soft tissues injuries. Open injuries should in theory be easier to identify and the repair of injured structures performed as soon as possible in order to obtain a satisfying outcome. Conversely, due to the reduced compliance of younger children during clinical assessment, the diagnosis of a closed nerve injury may sometimes be delayed. As the compliance of patients is influenced by pain, anxiety and stress, the execution of the clinical manoeuvres intended to identify a loss of motor function or sensibility, can be impaired. Although the majority of PNI are neuroapraxias resulting in spontaneous recovery, there are open questions regarding certain aspects of closed PNI, e.g. when to ask for electrophysiological exams, when and how long to wait for a spontaneous recovery and when a surgical approach becomes mandatory. The aim of the article is therefore to analyse the main aspects of the different closed PNI of the upper limb in order to provide recommendations for timely and correct management, and to determine differences in the PNI treatment between children and adults.

Cervical and Upper Limb Peripheral Nerve Injuries in Adults: Electrodiagnostic Studies and Symptoms

2017 ◽  
Vol 23 (3) ◽  
Author(s):  
Bina Eftekharsadat ◽  
Arash Babaei-Ghazani ◽  
Bahram Samadirad ◽  
Vida Mamaghany
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals FREQUENCY OF PERIPHERAL NERVE INJURIES IN ATHLETES OF CERTAIN SPORTS CLUBS IN THE CITY OF ZADAR

2021 ◽  
pp. 127-132
Author(s):  
Luka Androja ◽  
Josip Miočić ◽  
Žarko Bilić ◽  
Milica Komšo
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Soft Tissues ◽  
Original System ◽  
Rehabilitation Program ◽  
Professional Staff ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Training Process

Peripheral nerves in athletes are susceptible to injury due to an increase in physiological requirements in the training process to neurological structures and to the soft tissues that protect them. The training process is conditioned by the rank and level of competition and its implementation largely depends on the education of professional staff. Common mechanisms of injury are pressure, sprain, strain, ischemia, and sports injury. Seddon's original system of dividing nerve injuries based on neurophysiological changes is most widely used in medicine. The initial stage of nerve injury is neuropraxia, the second stage is axonal degeneration, and the third stage is nerve cutting. Peripheral nerve injuries are more common in the upper extremities than in the lower extremities. They have specifics related to a particular sport, in this case, football and basketball, and often have a biomechanical component in the making. Early detection allows an appropriate rehabilitation program to be initiated and biomechanics changed before the nerve injury becomes permanent. Recognizing nerve injury requires an understanding of peripheral neuroanatomy, knowledge of common nerve injury sites, and awareness of the types of peripheral nerve injuries that are common and specific to a particular sport. Rehabilitation programs in the field of kinesiology can be read through FMS protocols. Electrodiagnostic tests (electromyography), somatosensory evoked potentials, magnetic resonance imaging, and ultrasound are used to diagnose peripheral nerve injuries. Proximal peripheral nerve injuries have a slightly poorer prognosis in terms of neurological recovery in athletes. The survey determined the frequency of injuries in the subjects and that there is a misunderstanding among the athletes themselves, which is a peripheral nerve injury. The survey also found that peripheral nerve injuries occur due to acute injuries, while chronic injuries are excessive, resulting in damage to muscles and joints, and rarely as a result of inappropriate sports equipment. Athletes' knowledge of what constitutes a peripheral nerve injury itself and how this type of injury should be given more importance in further general prevention has also been established.

Tendon transfers after peripheral nerve injuries: my preferred techniques

2019 ◽  
Vol 44 (8) ◽  
pp. 775-784 ◽  
Author(s):  
Vincent R. Hentz
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Hand Function ◽  
Nerve Transfer ◽  
Peripheral Nerve Injuries ◽  
Reconstructive Procedure ◽  
Nerve Injuries ◽  
Postoperative Rehabilitation ◽  
Tendon Transfers ◽  
To Come

While there is now keen interest in restoring function lost through irreparable nerve injury by performing nerve-to-nerve transfer, for some time to come, tendon transfers will remain the primary reconstructive procedure for paralytic injuries of the upper limb. A career spanning more than 50 years has permitted the author to try many tendon transfers promoted by past and present colleagues for the three common nerve injuries (median, radial and ulnar) affecting hand function and, eventually, to settle upon those which have provided the most predictable and consistent outcomes. This article describes the author’s preferred tendon transfers for high radial and low median and ulnar palsies, providing the rationale behind these choices, operative details supplemented with illustrations, technical tips and advice regarding postoperative rehabilitation.

The Epidemiology and Management of Upper Limb Peripheral Nerve Injuries in Modern Practice

1996 ◽  
Vol 21 (1) ◽  
pp. 4-13 ◽  
Author(s):  
R. M. R. McALLISTER ◽  
S. E. A. GILBERT ◽  
J. S. CALDER ◽  
P. J. SMITH
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Upper Limb ◽  
Primary Repair ◽  
Nerve Repair ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Frequency Distributions ◽  
South East England ◽  
Delayed Referral

This paper reports an epidemiological and clinical study of 813 patients with 1,111 peripheral nerve injuries who were treated for upper limb trauma, which included nerve injury, at two plastic surgery units in south-east England, predominantly between the years 1982 and 1991. The frequency distributions of the levels of nerve injury, and the causes of nerve injury in the sample, are presented, together with the surgical management and timing of nerve repair in these patients. 1,018 clinically suspected nerve injuries in 730 patients (91.6% of nerves, 89.8% of patients) were treated by primary nerve repair, elective delayed nerve repair or primary surgical exploration alone. Divisions of 93 nerves in 83 patients (8.3% of nerves, 10.2% of patients) were treated other than by primary repair or elective delayed repair, due to delayed referral from accident and emergency departments, resulting from missed or uncertain diagnosis at presentation or otherwise unaccounted delay in the initial referral.

scholarly journals Clinical and functional evaluation in patients with upper limb disability following traumatic peripheral nerve injury. Part I

2015 ◽  
Vol 62 (3) ◽  
pp. 243-248
Author(s):  
Mariana-Isabela Moise (Constantinovici) ◽  
◽  
Adriana Sarah Nica ◽  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Biomedical Literature ◽  
Motor Dysfunction ◽  
Functional Evaluation ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Upper Limb Function ◽  
Neurologic Impairment

Background. Current studies regarding the consequences of upper limb traumatic peripheral nerve injuries adresses both sensory-motor dysfunction and functioning, disability and pain issues. Aims. This article presents an overview of the biomedical literature regarding the available assessment methodologies and outcome measures used in research and clinical practice for the evaluation of upper limb function in the therapeutic management of posttraumatic upper limb peripheral nerve injuries and disability and their impact on patient’s functioning, health and quality of life. Design. Systematic review of the international biomedical literature. Methods. We used PubMedCentral database searches (PMC) of the last 10 years published literature. There were excluded scientific abstracts and articles that did not match to our search criteria, such as studies on brachial plexus injury, diabetic neuropathy, upper limb neurologic impairment due to Stroke, TBI or SCI, etc. Results and discussion. We selected 20 studies from the identified articles. We presented an overview of the main assessment methodologies and functional parameteres investigated in these studies.

scholarly journals Brachial Plexus Neuropathies During the COVID-19 Pandemic: A Retrospective Case Series of 15 Patients in Critical Care

2020 ◽  
Vol 101 (1) ◽  
Author(s):  
Caroline Miller ◽  
Joel O'Sullivan ◽  
Jack Jeffrey ◽  
Dominic Power
Keyword(s):  
Critical Care ◽  
United Kingdom ◽  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Nerve Injury ◽  
Upper Limb ◽  
Case Series ◽  
Queen Elizabeth Hospital ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Abstract Objective The use of the prone position to treat patients with COVID-19 pneumonia who are critically ill and mechanically ventilated is well documented. This case series reports the location, severity, and prevalence of focal peripheral nerve injuries involving the upper limb identified in an acute COVID-19 rehabilitation setting. The purpose of this study was to report observations and to explore the challenges in assessing these patients. Methods Participants were patients with suspected peripheral nerve injuries following discharge from COVID-19 critical care who were referred to the peripheral nerve injury multidisciplinary team. Data were collected retrospectively on what peripheral neuropathies were observed, with reference to relevant investigation findings and proning history. Results During the first wave of the COVID-19 pandemic in the United Kingdom, 256 patients were admitted to COVID-19 critical care of Queen Elizabeth Hospital, Birmingham, United Kingdom. From March to June 2020, a total of 114 patients required prone ventilation. In this subgroup, a total of 15 patients were identified with clinical findings of peripheral nerve injuries within the upper limb. In total, 30 anatomical nerve injuries were recorded. The most commonly affected nerve was the ulnar nerve (12/30) followed by the cords of the brachial plexus (10/30). Neuropathic pain and muscle wasting were identified, signifying a high-grade nerve injury. Conclusion Peripheral nerve injuries can be associated with prone positioning on intensive care units, although other mechanisms, such as those of a neuroinflammatory nature, cannot be excluded. Impact Proning-related upper limb peripheral nerve injuries are not discussed widely in the literature and could be an area of further consideration when critical care units review their proning protocols. Physical therapists treating these patients play a key part in the management of this group of patients by optimizing the positioning of patients during proning, making early identification of peripheral nerve injuries, providing rehabilitation interventions, and referring to specialist services if necessary. Lay Summary During the COVID-19 pandemic, patients who are very ill can be placed for long periods of time on their stomach to improve their chances of survival. The potential consequences of prolonged time in this position are weakness and pain in the arms due to potential nerve damage. There are some recommended treatments to take care of these problems.

scholarly journals Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

2014 ◽  
Vol 9 (6) ◽  
pp. 661 ◽  
Author(s):  
Xiaolin Liu ◽  
Jiakai Zhu ◽  
Bo He ◽  
Zhaowei Zhu ◽  
Qingtang Zhu ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Motor Recovery ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals Clinical and functional evaluation in patients with upper limb disability following traumatic peripheral nerve injury. Part II

2015 ◽  
Vol 62 (4) ◽  
pp. 367-370
Author(s):  
Mariana-Isabela Moise (Constantinovici) ◽  
◽  
Adriana Sarah Nica ◽  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Biomedical Literature ◽  
Motor Dysfunction ◽  
Functional Evaluation ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Upper Limb Function ◽  
Neurologic Impairment

Background. Current studies regarding the consequences of upper limb traumatic peripheral nerve injuries adresses both sensory-motor dysfunction and functioning, disability and pain issues. Aims. This article presents an overview of the biomedical literature regarding the available assessment methodologies and outcome measures used in research and clinical practice for the evaluation of upper limb function in the therapeutic management of posttraumatic upper limb peripheral nerve injuries and disability and their impact on patient’s functioning, health and quality of life. Design. Systematic review of the international biomedical literature. Methods. We used PubMedCentral database searches (PMC) of the last 10 years published literature. There were excluded scientific abstracts and articles that did not match to our search criteria, such as studies on brachial plexus injury, diabetic neuropathy, upper limb neurologic impairment due to Stroke, TBI or SCI, etc. Results and discussion. We selected 20 studies from the identified articles. We presented an overview of the main assessment methodologies and functional parameters investigated in these studies.

Sign in / Sign up

Export Citation Format

Share Document