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Peripheral Nerve Injuries And Surgery Results

Year 2021, Volume: 9 Issue: 1, 71 - 77, 25.03.2021
https://doi.org/10.33715/inonusaglik.814404

Abstract

Peripheral nerve injuries (PNI) are major causes of disability. PNI generally occurs as the result of firearm injuries, penetrating and blunt traumas. Although improvement is seen in partial incisions of PNI, recovery is rare in complete incisions and these cases are candidates for surgical operation. Differences about the type of surgical intervention and the timing of the surgery are seen in many studies. There exists different surgical procedures in PNI. Electromyelography (EMG) findings are important in diagnosis and follow-up, and guide this issue. In this research, a study that will contribute to the literature with the long-term clinical results of patients who underwent surgery for peripheral nerve trauma at the Inonu University Neurosurgery Clinic has been made. 15 patients who underwent surgery for PNI were evaluated according to; age, gender, type of trauma, pre- and postoperative EMG findings, pre- and postoperative neurological examination results. Pearson Chi-square tests were used for statistical analysis. Statistically, p <0.05 results were considered significant. IBM SPSS Statistics 26.0 program was used for analysis. As the result; although the recovery rate in patients with PNI more than 1 year is low, this rate was higher in our study. Therefore, we recommend surgical intervention to all patients regardless of the post-traumatic period.

References

  • Baysefer, A., İzci, Y., Akay, K. M., Kayalı, H., Timurkaynak E. (2004). Surgical outcomes of ulnar nerve lesions in children. A retrospective clinical study. Pediatric Neurosurgery, 40(3), 107-11.
  • Damien, P. K., Christian, F . (2020). Restoration of Neurological Function Following Peripheral Nerve Trauma, International Journal of Molecular Sciences, 21(5), 1808.
  • Daneyemez, M., Solmaz, I., İzci, Y. (2005). Prognostic factors for the surgical management of peripheral nerve lesions. The Tohoku Journal of Experimental Medicine, 205(3), 269-75.
  • Ertem, K., Denizhan, Y., Yoloğlu, S., Bora, A. (2005). The effect of injury level, associated injuries, the type of nerve repair, and age on the prognosis of patients with median and ulnar nerve injuries. Acta Orthopaedica et Traumatologica Turcica, 39(4), 322-327.
  • Garozzo, D., Ferraresi, S., Buffatti, P. (2004).Surgical treatment of common peroneal nerve injuries: Indications and results. A series of 62 cases. Journal of Neurosurgical Sciences, 48(3), 105-112.
  • Gezercan, Y., Menekşe, G., Ökten, İ. A., Arslan, A., Özsoy K. M., Ateş, T., … Güzel, A. (2016). The Outcomes of Late Term Surgical Treatment of Penetrating Peripheral Nerve Injuries. Turkish Neurosurgery, 26(1), 146-52.
  • Horteur, C., Forli, A., Corcella, D., Pailhe, G., Lateur, G., Saragaglia, D. (2019) Short- and long-term results of common peroneal nerve injuries treated by neurolysis, direct suture or nerve graft. European Journal of Orthopaedic Surgery & Traumatology, 29(4), 893–898.
  • Koller, R., Rath, T., Benditte, H., Klepetko, H., Eberhard, D., Millesi, H. (1998). Results of restoration of continuity in peripheral nerves in childhood and adolescence. Handchirurgie · Mikrochirurgie · Plastische Chirurgie, 30(2), 109-115.
  • Kuran, İ., Özcan, H., Kuran, B., Aydın, H. (1995). The surgical approach to peripheral nerve repair. Acta Orthopaedica et Traumatologica Turcica, 29, 37-40.
  • Noble, J., Munro, C. A., Prasad, V. S., Midha, R. (1998). Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multipl injuries. Journal of Trauma, 45(1), 116-122.
  • Rochkind, S., Filmar, G., Kluger, Y., Alon, M. (2007). Microsurgical management of penetrating peripheral nerve injuries: Pre, intra- and postoperative analysis and results. Acta Neurochirurgica Supplement, 100, 21-24.
  • Seçer H. I., Daneyemez M., Gönül E., İzci Y. (2007). Surgical repair of ulnar nerve lesions caused by gunshot and shrapnel: results in 407 lesions. Journal of Neurosurgery, 107(4), 776-83.
  • Seçer H. I, Daneyemez M., Tehli O., Gönül E., İzci Y. (2008).The clinical, electrophysiologic, and surgical characteristics of peripheral nerve injuries caused by gunshot wounds in adults: a 40-year experience. Surgical Neurology, 69(2), 143-52.
  • Taylor, C. A, Braza, D., Rice, J. B., Dillingham, T. (2008).The incidence of peripheral nerve injury in extremity trauma. American Journal of Physical Medicine & Rehabilitation, 87(5), 381-385.
  • Topuz, A. K., Eroğlu, A., Atabey, C., Çetinkal, A. (2013). Surgical treatment outcomes in peripheral nerve lesions due to gunshot injuries: Assessment of 28 cases. Ulus Travma Acil Cerrahi Dergisi, 19(3), 235- 40.
  • Topuz, A. K., Eroğlu, A., Atabey, C., Göçmen, S., Kutlay, M., Demircan, M. N. (2011). Periferik sinir yaralanmalarında geç dönem cerrahi tedavi sonuçlarımız. Türk Nöroşirürji Dergisi, 21(1), 8-13.

PERİFERİK SİNİR YARALANMALARI VE CERRAHİ SONUÇLARI

Year 2021, Volume: 9 Issue: 1, 71 - 77, 25.03.2021
https://doi.org/10.33715/inonusaglik.814404

Abstract

Periferik sinir yaralanmaları (PSY) önemli sakatlık nedenidir. PSY genelde ateşli silah yaralanmaları, penetran ve künt travmalar sonucunda meydana gelmektedir. PSY’de kısmi kesilerde iyileşme görülmesine karşın, tam kesilerde iyileşme daha nadir olur ve bu vakalar cerrahi operasyona adaydır. Birçok çalışmada cerrahi müdahalenin şekli ve cerrahi zamanlamada farklılıklar görülmektedir. PSY’de farklı cerrahi prosedürler mevcuttur. Electromyelography (EMG) bulguları tanı ve takipte önemli olup bu konuda yol göstericidir. Bu araştırmada, İnönü Üniversitesi Beyin Cerrahisi kliniğinde periferik sinir travması nedeniyle cerrahi operasyon yapılmış olan hastaların uzun dönem klinik sonuçları ile literatüre katkısı olacak bir çalışma yapılmıştır. PSY nedeniyle cerrahi operasyon yapılan 15 hasta; yaş, cinsiyet, travma türü, ameliyat öncesi ve sonrası EMG bulguları, ameliyat öncesi ve sonrası nörolojik muayene sonuçları açısından değerlendirildi. İstatistik analizlerde Pearson Ki-kare testleri kullanıldı. İstatistiksel olarak p<0,05 çıkan sonuçlar anlamlı kabul edildi. Analizlerde IBM SPSS Statistics 26.0 programı kullanıldı. Sonuç olarak; PSY’lerinde bir yılı aşan tedavi edilmemiş hastalarda iyileşme oranı düşük olsa da çalışmamızda bu oran daha yüksek çıkmıştır. Bundan dolayı, travma sonrası süreye bakılmaksızın tüm hastalara cerrahi müdahale önermekteyiz.

References

  • Baysefer, A., İzci, Y., Akay, K. M., Kayalı, H., Timurkaynak E. (2004). Surgical outcomes of ulnar nerve lesions in children. A retrospective clinical study. Pediatric Neurosurgery, 40(3), 107-11.
  • Damien, P. K., Christian, F . (2020). Restoration of Neurological Function Following Peripheral Nerve Trauma, International Journal of Molecular Sciences, 21(5), 1808.
  • Daneyemez, M., Solmaz, I., İzci, Y. (2005). Prognostic factors for the surgical management of peripheral nerve lesions. The Tohoku Journal of Experimental Medicine, 205(3), 269-75.
  • Ertem, K., Denizhan, Y., Yoloğlu, S., Bora, A. (2005). The effect of injury level, associated injuries, the type of nerve repair, and age on the prognosis of patients with median and ulnar nerve injuries. Acta Orthopaedica et Traumatologica Turcica, 39(4), 322-327.
  • Garozzo, D., Ferraresi, S., Buffatti, P. (2004).Surgical treatment of common peroneal nerve injuries: Indications and results. A series of 62 cases. Journal of Neurosurgical Sciences, 48(3), 105-112.
  • Gezercan, Y., Menekşe, G., Ökten, İ. A., Arslan, A., Özsoy K. M., Ateş, T., … Güzel, A. (2016). The Outcomes of Late Term Surgical Treatment of Penetrating Peripheral Nerve Injuries. Turkish Neurosurgery, 26(1), 146-52.
  • Horteur, C., Forli, A., Corcella, D., Pailhe, G., Lateur, G., Saragaglia, D. (2019) Short- and long-term results of common peroneal nerve injuries treated by neurolysis, direct suture or nerve graft. European Journal of Orthopaedic Surgery & Traumatology, 29(4), 893–898.
  • Koller, R., Rath, T., Benditte, H., Klepetko, H., Eberhard, D., Millesi, H. (1998). Results of restoration of continuity in peripheral nerves in childhood and adolescence. Handchirurgie · Mikrochirurgie · Plastische Chirurgie, 30(2), 109-115.
  • Kuran, İ., Özcan, H., Kuran, B., Aydın, H. (1995). The surgical approach to peripheral nerve repair. Acta Orthopaedica et Traumatologica Turcica, 29, 37-40.
  • Noble, J., Munro, C. A., Prasad, V. S., Midha, R. (1998). Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multipl injuries. Journal of Trauma, 45(1), 116-122.
  • Rochkind, S., Filmar, G., Kluger, Y., Alon, M. (2007). Microsurgical management of penetrating peripheral nerve injuries: Pre, intra- and postoperative analysis and results. Acta Neurochirurgica Supplement, 100, 21-24.
  • Seçer H. I., Daneyemez M., Gönül E., İzci Y. (2007). Surgical repair of ulnar nerve lesions caused by gunshot and shrapnel: results in 407 lesions. Journal of Neurosurgery, 107(4), 776-83.
  • Seçer H. I, Daneyemez M., Tehli O., Gönül E., İzci Y. (2008).The clinical, electrophysiologic, and surgical characteristics of peripheral nerve injuries caused by gunshot wounds in adults: a 40-year experience. Surgical Neurology, 69(2), 143-52.
  • Taylor, C. A, Braza, D., Rice, J. B., Dillingham, T. (2008).The incidence of peripheral nerve injury in extremity trauma. American Journal of Physical Medicine & Rehabilitation, 87(5), 381-385.
  • Topuz, A. K., Eroğlu, A., Atabey, C., Çetinkal, A. (2013). Surgical treatment outcomes in peripheral nerve lesions due to gunshot injuries: Assessment of 28 cases. Ulus Travma Acil Cerrahi Dergisi, 19(3), 235- 40.
  • Topuz, A. K., Eroğlu, A., Atabey, C., Göçmen, S., Kutlay, M., Demircan, M. N. (2011). Periferik sinir yaralanmalarında geç dönem cerrahi tedavi sonuçlarımız. Türk Nöroşirürji Dergisi, 21(1), 8-13.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Araştırma Makalesi
Authors

Ramazan Paşahan 0000-0002-3221-1422

Cengiz Gölçek 0000-0002-1969-9080

Emek Güldoğan 0000-0002-5436-8164

Publication Date March 25, 2021
Submission Date October 21, 2020
Acceptance Date December 20, 2020
Published in Issue Year 2021 Volume: 9 Issue: 1

Cite

APA Paşahan, R., Gölçek, C., & Güldoğan, E. (2021). PERİFERİK SİNİR YARALANMALARI VE CERRAHİ SONUÇLARI. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(1), 71-77. https://doi.org/10.33715/inonusaglik.814404