Izvorni znanstveni članak

https://doi.org/10.20471/acc.2018.57.03.12

Management of Brachial Plexus Missile Injuries

Lukas Rasulić orcid.org/0000-0002-5674-0425 ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
Vesna Simić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Section for Neurosurgery, Department of Surgery, Ćuprija General Hospital, Ćuprija, Serbia
Andrija Savić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
Milan Lepić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia
Vojin Kovačević ; Department of Neurosurgery, Kragujevac Clinical Center, Kragujevac, Serbia; Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Vladimir Puzović ; Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Filip Vitošević ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia
Nenad Novaković ; Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia
Miroslav Samardžić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
Krešimir Rotim ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences

Sažetak

Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. The aim was to evaluate functional recovery after surgical treatment of these injuries. Our series included 68 patients with 202 nerve lesions treated with 207 surgical procedures. Decision on the treatment modality (exploration, neurolysis, graft repair, or combination) was made upon intraoperative finding. Results were analyzed in 60 (88.2%) patients with 173 (85.6%) nerve lesions followed-up for two years. Functional recovery was evaluated according to functional priorities. Satisfactory functional recovery was achieved in 90.4% of cases with neurolysis and 85.7% of cases with nerve grafting. Insufficient functional recovery was verified in ulnar and radial nerve lesions after neurolysis, and in median and radial nerve lesions when graft repair was done. We conclude that the best time for surgery is between two and four months after injury, except for the gunshot wound associated with injury to the surrounding structures, which requires immediate surgical treatment. The results of neurolysis and nerve grafting were similar.

Ključne riječi

Brachial plexus; Neurosurgical procedures; Nerve block; Traumatology; Recovery of function

Hrčak ID:

216142

URI

https://hrcak.srce.hr/216142

Datum izdavanja:

1.9.2018.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.152 *