scholarly journals SURGICAL TREATMENT OF PERIPHERAL NERVES COMBAT WOUNDS OF THE EXTREMITIES

2021 ◽  
Vol 74 (3) ◽  
pp. 619-624
Author(s):  
Vitalii I. Tsymbaliuk ◽  
Sergii S. Strafun ◽  
Ihor B. Tretyak ◽  
Iaroslav V. Tsymbaliuk ◽  
Alexander A. Gatskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Pain Syndrome ◽  
Common Peroneal Nerve ◽  
Combat Trauma ◽  
Diagnostic Measures ◽  
Combat Injuries ◽  
Recovery Of Motor Function ◽  
Degree Of Recovery

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.

scholarly journals Minimal Invazive Surgical Treatment of Piriformis Syndrome and the Results

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Conservative Treatment ◽  
Surgical Procedures ◽  
Pain Syndrome ◽  
Anatomical Variations ◽  
Clinical Findings ◽  
Piriformis Syndrome ◽  
Minimally Invasive Surgical ◽  
Magnetic Resonance Imaging Mri

Piriformis syndrome is a neuromuscular pain syndrome occurring as a result of compression on the underlying sciatic nerve due to various causes including the hypertrophy, inflammation, mass lesions or anatomical variations occuring in the deep gluteal space. Patients with piriformis syndrome often experience pain and numbness in the hip, thigh and leg, similar to those of sciatica. In addition to clinical findings, electrophysiological examinations and magnetic resonance imaging (MRI) is useful for diagnosis. Once diagnosed, the treatment approach is stepwise and conservative treatment is successful in majority of cases. Surgical treatment should be performed for the cases in whom conservative treatment methods fail and when the sciatic nerve should be decompressed. Surgery is an important treatment option for unresolved piriformis syndrome with its simplicity and low morbidity. Several surgical procedures have been described for the decompression of affected sciatic nerve. Due to excessive fibrosis tissue that may be developed around the sciatic nerve in classical surgical procedures, person's return to social and work life may be delayed. In the present study, we will evaluate the surgical indication criteria of our cases who underwent minimally invasive surgical treatment due to piriformis syndrome, the definition of the surgical procedure and the outcomes.

Возможности ультразвукового исследования в диагностике диабетической периферической полинейропатии нижних конечностей у детей 5-17 лет

2019 ◽  
pp. 64-86
Keyword(s):  
Diabetes Mellitus ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Lower Extremities ◽  
Common Peroneal Nerve ◽  
Nerve Ultrasound

Билатерально исследованы 840 периферических нервов нижних конечностей (седалищные, большеберцовые и общие малоберцовые нервы). Контрольную группу составили 480 нервных стволов 80 здоровых детей в возрасте от 5 до 17 лет, основную - 360 нервных стволов 60 детей, страдающих сахарным диабетом 1-го типа, в возрасте от 5 до 17 лет. Всем пациентам основной группы проведена электронейромиография. Основная группа разделена на две подгруппы: в подгруппу А вошли 126 нервных стволов 21 ребенка в возрасте от 5 до 17 лет с нормальными показателями электронейромиографии периферических нервов нижних конечностей; в подгруппу Б - 234 нервных ствола 39 детей в возрасте от 8 до 17 лет, у которых при электронейромиографии выявлены нарушения невральной проводимости отдельных нервов. Для оценки размеров нервов дополнительно проведено внутригрупповое разделение на 4 возрастные категории (5-7 лет, 8-10 лет, 11-13 лет, 14-17 лет). Всем паци ентам выполнено ультразвуковое иссле дование нервов нижних конечностей на аппарате DC-8 (Mindray, Китай) широкополосными линейными датчиками с диапазоном частот 3-12 и 6-14 МГц. Оценке подвергались следующие параметры: площадь поперечного сечения нерва (при поперечном сканировании), его эхоструктура и контуры (при продольном сканировании) (для каждого нерва на двух уровнях). Площадь поперечного сечения седалищного нерва при сахарном диабете 1-го типа у детей старше 11 лет достоверно больше (P 0,05) по сравнению с контрольной группой. Достоверные различия (P 0,05) по площади поперечного сечения седалищного нерва между подгруппами А и Б определялись только на проксимальном уровне и только у детей старше 14 лет. Площадь поперечного сечения большеберцового нерва при сахарном диабете 1-го типа у детей старше 11 лет достоверно больше (P 0,05) по сравнению с контрольной группой. Тест “отсутствие чере дования линейных структур пониженной и повышенной эхогенности (однородная эхоструктура на фоне пониженной эхогенности или практически однородная эхоструктура на фоне повышенной эхогенности и едва различимых линейных гипоэхогенных структур) большеберцового нерва - диабетическая периферическая нейропатия” у детей с сахарным диабетом 1-го типа характеризовался чувствительностью 71,8%, специфичностью 100,0%, AUC 0,859. Тест “практически однородная эхоструктура на фоне повышенной эхогенности и едва различимых линейных гипоэхогенных структур большеберцового нерва - диабетическая периферическая нейропатия” у детей с сахарным диабетом 1-го типа характеризовался чувствительностью 66,7%, специфичностью 100,0%, AUC 0,833. Достоверные различия между степенями компенсации сахарного диабета 1-го типа при оценке эхоструктуры седалищного и большеберцового нервов определяются только в подгруппе Б (P = 0,000 для обоих сравнений). Получена достоверная (P 0,05) положительная корреляция между значениями площади поперечного сечения исследованных нервов на всех уровнях измерения и возрастом паци ентов в контрольной (rS - 0,54-0,90) и основной (rS - 0,17-0,62) группах и между значениями площади поперечного сечения исследованных нервов на всех уровнях измерения и стажем сахарного диабета 1-го типа в основной группе (rS - 0,40-0,57). Ультразвуковое исследование периферических нервов нижних конечностей может быть использовано в диагностике диабетической периферической нейропатии у детей с сахарным диабетом 1-го типа. Ключевые слова: ультразвуковое исследование нервов, сахарный диабет, диабетическая дистальная полинейропатия, периферические нервы, седалищный нерв, большеберцовый нерв, общий малоберцовый нерв, нижние конечности, дети, nerve ultrasound, diabetes mellitus, diabetic distal polyneuropathy, peripheral nerves, sciatic nerve, tibial nerve, common peroneal nerve, lower extremities, children

THE HARMFUL COMPLICATIONS OF PERIPHERAL NERVES IN NEUROSURGICAL PRACTICE

Vestnik ◽  
2021 ◽  
pp. 131-135
Author(s):  
Е.К. Дюсембеков ◽  
А.Р. Халимов ◽  
И.Т. Курмаев ◽  
А.В. Николаева ◽  
А.С. Жайлаубаева ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Preventive Measures ◽  
Nerve Injuries ◽  
Absolute Value ◽  
Iatrogenic Injuries ◽  
Common Causes ◽  
Working Age ◽  
Late Referral

Проведено исследование 93 пациентов с ятрогенными повреждениями периферических нервов, 11,7% по отношению ко всем оперированным пациентам. Женщин было 51, мужчин 42. Пациенты трудоспособного возраста составили 88%. Позднее обращение за специализированной нейрохирургической помощью составило 53,7%. Чаще всех повреждался седалищный нерв - 29,1%, затем лучевой нерв - 22,6%. Наиболее частые причины ятрогенных осложнений - это операции на опорно-двигательном аппарате (79 - 84,9%). Представлены виды оперативных вмешательств, предложены меры по профилактике и своевременному специализированному лечению больных с ятрогенными повреждениями нервов. Research has been done of 93 patients with iatrogenic injuries of peripheral nerves. It amounted to 11,7 per cent of all patients, who received surgical treatment. In the absolute value, there were 51 men and 42 women in gender equivalent. The significant quantity of working age patients amounts to 88%. 53.7% - it is late referral to specialized neurosurgical care. The volume of sciatic nerve injuries was the largest and amounted to 29,1%, the next a radial nerve - 22,6%. Most common causes of harmful complications there are operations on the musculoskeletal system (79 - 84,9%).The article shows the types of surgery, preventive measures and timely specialized treatment of patients with iatrogenic nerve injuries were proposed

scholarly journals FAST-PROTOCOL AND INTERVENTIONAL SONOGRAPHY IN THE DIAGNOSTIC AND TREATMENT OF COMBAT INJURIES OF THE ABDOMEN

2021 ◽  
pp. 116-120
Author(s):  
I. P. Khomenko ◽  
K. R. Muradian ◽  
V. Yu. Shapoval ◽  
O. S. Herasymenko ◽  
Ya. I. Haida ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diagnostic Tests ◽  
Ultrasound Guidance ◽  
Treatment Time ◽  
Combat Trauma ◽  
Control Group ◽  
Abdominal Injuries ◽  
Surgical Interventions ◽  
Combat Injuries ◽  
Comparison Groups

Summary. The aim — improvement of diagnostic and surgical treatment of wounded abdominal injuries by introducing emergency ultrasound techniques and mini-invasive surgery under the control of ultrasound imaging. Materials and methods. A clinical and statistical analysis of the results of surgical treatment of 293 wounded with combat injuries of the abdomen who underwent treatment in military mobile hospitals was carried out. In the comparison of the wounded with combat injuries of the abdomen, additional diagnostic tests were carried out in the comparison groups — FAST protocol, puncture sanitation and draining surgical interventions under ultrasound navigation. Results and discussion. In the main group, unlike the control group, all wounded were followed by the FAST protocol. Widespread introduction into the diagnostic program of FAST-protocol and diagnostic punctures under ultrasound navigation allows to reduce the level of more traumatic diagnostic laparocentheses from 24.7 to 2.2 % and unreasonable surgical interventions from 3.2 to 0.7 %. Based on the results of the study, we have developed an algorithm for diagnostic and therapeutic actions for the wounded with combat trauma to the abdomen according to the results of the FAST-protocol. Conclusions. The data obtained indicate that the widespread adoption of the FAST protocol, transcutaneous puncture sanitation interventions under ultrasound guidance in the diagnosis and treatment of combat abdominal trauma and its complications contribute to a decrease in the number of invasive and more traumatic (often unreasonable) diagnostic and treatment methods, which leads to faster recovery and shortened treatment time.

Tactics of surgical treatment of traction injury of sciatic nerve combined with fracture of femur

2018 ◽  
Vol 16 (7(part 1)) ◽  
pp. 77-80
Author(s):  
A. A. Bogov ◽  
◽  
V. G. Ignatyev ◽  
M. R. Zhuravlev ◽  
I. G. Khannanova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Traction Injury

Prevention of painful neuromas by oblique transection of peripheral nerves

2006 ◽  
Vol 104 (2) ◽  
pp. 285-289 ◽  
Author(s):  
Wieslaw Marcol ◽  
Katarzyna Kotulska ◽  
Magdalena Larysz-Brysz ◽  
Grazyna Bierzyñska-Macyszyn ◽  
Pawel Wlaszczuk ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Traditional Method ◽  
Healing Process ◽  
Nerve Transection ◽  
Proximal Stump ◽  
Sciatic Nerves ◽  
Neuroma Formation

Object Neuroma formation often occurs at the proximal stump of the transected nerve, complicating the healing process after gap injuries or nerve biopsies. Most such neuromas cause therapy-resistant neuropathic pain. The purpose of this study was to determine whether oblique transection of the proximal stump of the sciatic nerve can prevent neuroma formation. Methods The sciatic nerves of 10 rats were transected unilaterally at an angle of 30°, and the peripheral segments of the nerves were removed. In 10 control animals the sciatic nerves were transected at a perpendicular angle. Twenty weeks after surgery the nerves were reexposed and collected. The presence of neuromas was determined by two board-certified pathologists on the basis of histopathological evaluations. Conclusions The oblique transection of peripheral nerves, contrary to perpendicularly transected nerves, is rarely followed by classic neuroma development. Moreover, neuropathic pain is significantly reduced compared with that following the traditional method of nerve transection.

Metallothionein deficiency in the injured peripheral nerves of complex regional pain syndrome as revealed by proteomics

Pain ◽  
2012 ◽  
Vol 153 (3) ◽  
pp. 532-539 ◽  
Author(s):  
Gosuke Oki ◽  
Takuro Wada ◽  
Kosuke Iba ◽  
Hikono Aiki ◽  
Kouichi Sasaki ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Peripheral Nerves ◽  
Pain Syndrome

On the issue of damage to the nerve trunks during intramuscular injections

1937 ◽  
Vol 33 (5) ◽  
pp. 590-596
Author(s):  
Sh. V. Bikchurin ◽  
E. I. Eselevich
Keyword(s):  
Sciatic Nerve ◽  
Injection Site ◽  
Peripheral Nerves ◽  
Intramuscular Injections

Cases of damage to the nerve trunks during intramuscular injections are now quite rare, since they can be avoided by strictly observing the rules for choosing the injection site. In the old manuals of Oppenheim and Lewandowski and in the newest manuals of Kraus and Brugsch (Toby Cohn), injections of various medications are indicated as the etiological moment of damage to the sciatic nerve. Injections of quinine and its compounds in the treatment of malaria, as well as injections of bioquinol, in some cases cause injury to peripheral nerves.

scholarly journals S100ß and fibroblast growth factor-2 are present in cultured Schwann cells and may exert paracrine actions on the peripheral nerve injury

2008 ◽  
Vol 23 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Tatiana Duobles ◽  
Thais de Sousa Lima ◽  
Beatriz de Freitas Azevedo Levy ◽  
Gerson Chadi
Keyword(s):  
Growth Factor ◽  
Sciatic Nerve ◽  
Fibroblast Growth Factor ◽  
Schwann Cells ◽  
Nerve Injury ◽  
Satellite Cells ◽  
Peripheral Nerves ◽  
Fibroblast Growth Factor 2 ◽  
Fibroblast Growth ◽  
Cultured Schwann Cells

PURPOSE: The neurotrophic factor fibroblast growth factor-2 (FGF-2, bFGF) and Ca++ binding protein S100ß are expressed by the Schwann cells of the peripheral nerves and by the satellite cells of the dorsal root ganglia (DRG). Recent studies have pointed out the importance of the molecules in the paracrine mechanisms related to neuronal maintenance and plasticity of lesioned motor and sensory peripheral neurons. Moreover, cultured Schwann cells have been employed experimentally in the treatment of central nervous system lesions, in special the spinal cord injury, a procedure that triggers an enhanced sensorymotor function. Those cells have been proposed to repair long gap nerve injury. METHODS: Here we used double labeling immunohistochemistry and Western blot to better characterize in vitro and in vivo the presence of the proteins in the Schwann cells and in the satellite cells of the DRG as well as their regulation in those cells after a crush of the rat sciatic nerve. RESULTS: FGF-2 and S100ß are present in the Schwann cells of the sciatic nerve and in the satellite cells of the DRG. S100ß positive satellite cells showed increased size of the axotomized DRG and possessed elevated amount of FGF-2 immunoreactivity. Reactive satellite cells with increased FGF-2 labeling formed a ring-like structure surrounding DRG neuronal cell bodies.Reactive S100ß positive Schwann cells of proximal stump of axotomized sciatic nerve also expressed higher amounts of FGF-2. CONCLUSION: Reactive peripheral glial cells synthesizing FGF-2 and S100ß may be important in wound repair and restorative events in the lesioned peripheral nerves.

Sign in / Sign up

Export Citation Format

Share Document