Comparative characteristic of neurotization application and autologous nerve plastic surgery in proximal damage to the nerves of the upper extremities
Abstract
Aim. To assess the advantages and disadvantages of the neurotization technique for proximal damage to the nerves of the upper extremities.
Material and methods. The work presents a comparative description of the methods of reconstruction of the nerves of the upper limb with proximal injuries for 61 patients like neurotization and autologous nerve plastic surgery. All patients, for the convenience of the assessment of the immediate and long-term results, were divided into clinical groups: group I consisted of 28 patients who underwent neurotic methods; Group II included 33 patients who underwent autologous nerve plastic surgery.
Results and discussion. When studying functional recovery 12 months after reconstructive operations on the nerves of the upper extremities, an improvement was noted in the neurotization group: in the first group, the average disability was 47.4±1.9%, in the second -59.8±2.3%. The results of the assessment of discriminatory sensitivity, thermometry, as well as electroneuromyography also confirmed the advantage of using neurotization.
Conclusion. The data obtained suggest that the neurotic technique is more preferable than autologous nerve plastic surgery, especially in case of severe damage to the nerve trunks of the upper limbs. The use of switching operations for proximal lesions of the nerves of the upper extremities has proved to be effective and appropriate, both from a functional point of view and from a practical one.
About the Authors
G. M. Khojamuradov
Republican Scientific Center for Cardiovascular Surgery
Tajikistan
Tajikistan
Khojamuradov Gafur Mukhammadmukhsinovich - Doctor of Medical Sciences, Leading Researcher of the Department of Reconstructive Surgery
A. A. Davlatov
Republican Scientific Center for Cardiovascular Surgery
Tajikistan
Tajikistan
H. I. Satorov
Republican Scientific Center for Cardiovascular Surgery
Tajikistan
Tajikistan
A. Kh. Shaymonov
Republican Scientific Center for Cardiovascular Surgery
Tajikistan
Tajikistan
References
1. Bekhterev A. V. Taktika pri povrezhdenii perifericheskikh nervov verkhney konechnosti [Tactics for peripheral nerve injuries of the upper extremity]. Glavnyy vrach Yuga Rossii - Chief Physician of the South of Russia, 2017, No. 4 (57), pp. 28 – 32.
2. Zhurbin E. A. Vozmozhnosti ultrazvukovogo issledovaniya pri travmaticheskikh povrezhdeniyakh perifericheskikh nervov konechnostey [Possibilities of Ultrasound in Traumatic Peripheral Nerve Injuries of the Limbs]. Rossiyskiy elektronnyy zhurnal luchevoy diagnostiki - Russian electronic journal of radiation diagnostics, No. 7 (3), pp. 127-135.
3. Zhurbin E. A. Diagnosticheskaya tochnost ultrazvukovogo issledovaniya pri povrezhdeniyakh perifericheskikh nervov konechnostey [Diagnostic Accuracy of Ultrasound in Limb Peripheral Nerve Damage]. Vestnik Rossiyskoy voenno-meditsinskoy akademii - Bulletin of the Russian Military Medical Academy, No. 3, pp. 63-68.
4. Zikiryakhodzhaev D. Z. Sravnitelnye aspekty raka kozhi, razvivshegosya iz rubtsov-posledstviy sandalovogo ozhoga, i raka, razvivshegosya na neizmennoy kozhe [Comparative aspects of skin cancers that developed from the scarring effects of sandalwood burns and those that developed on unchanged skin]. Zdravookhranenie Tadzhikistana – Healthcare of Tajikistan, 2017, No. 1, pp. 20-24;
5. Klimkin A. V. Ultrazvukovoe issledovanie kharaktera porazheniya sredinnogo nerva pri sindrome zapyastnogo kanala [Ultrasound examination of median nerve lesions in carpal tunnel syndrome]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova - Journal of Neurology and Psychiatry named after S.S. Korsakov, 2016, Vol. 116, No. 6, pp. 25-30.
6. Kalinin R. E. Varianty klinicheskoy anatomii arteriy verkhnikh konechnostey [Variants of clinical anatomy of the arteries of the upper extremities]. Vestnik Avitsenny – Herald of Avicenna, No. 19 (1), pp. 113-119.
7. Salimov N. F. Dinamika pokazateley detskogo travmatizma v Tadzhikistane [Dynamics of Child Injury Rates in Tajikistan]. Zdravookhranenie Tadzhikistana Healthcare of Tajikistan, 2015, No. 3, pp. 54.
8. Churikov L. I. Sovremennye aspekty khirurgii povrezhdeniy luchevogo nerva [Current aspects of radial nerve injury surgery]. Vestnik Rossiyskoy voenno-meditsinskoy akademii - Bulletin of the Russian Military Medical Academy, No. 4, pp. 14-18.
9. Tsymbalyuk V. I. Kontseptsiya vosstanovleniya funktsii konechnosti pri travmaticheskom povrezhdenii perifericheskikh nervov [Concept of limb function restoration in traumatic peripheral nerve injury]. Ukraӣnskiy neyrokhіrurgіchniy zhurnal - Ukrainian neurosurgical journal, No. 3, p. 48-54.
10. Churikov L. I., Gaivoronsky, A. I., Zhurbin, E. A., Svistov, D. V., Alekseev D. E. Modern aspects of surgery for damage to the radial nerve. Bulletin of the Russian Military Medical Academy, No. 4, pp. 14-18.
11. Kalinin R. E., Suchkov I. A., Mzhvananadze N. D., Mustafaev, R. M. Clinical anatomy options for upper limb arteries. Bulletin of Avicenna, No. 19 (1), pp. 113-119;
12. Gordon T. Electrical stimulation to enhance axon regeneration after peripheral nerve injuries in animal models and humans. Neurotherapeutics, 2016, Vol. 13, No. 2, pp. 295-310.
13. Zuniga J., Tay A. B. Nerve injuries and repair. Operative Oral and Maxillofacial Surgery, 2017, No. 3, pp. 75-81.
14. Korus L., Ross, D. C., Doherty, C. D., & Miller, T. A. (2016). Nerve transfers and neurotization in peripheral nerve injury, from surgery to rehabilitation. Journal of Neurology, Neurosurgery and Psychiatry, No. 87 (2), pp. 188-197.
15. Sullivan R., Dailey T., Duncan K., Abel N., Borlongan C. Peripheral nerve injury: stem cell therapy and peripheral nerve transfer. International journal of molecular sciences, No. 17 (12), pp. 2101.
Review
For citations:
Khojamuradov G.M., Davlatov A.A., Satorov H.I., Shaymonov A.Kh. Comparative characteristic of neurotization application and autologous nerve plastic surgery in proximal damage to the nerves of the upper extremities. Health care of Tajikistan. 2020;(4):67-71. (In Russ.)
Views:
242
Email this article 