Articles: peripheral-nerve-injuries.
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The authors examined the American Society of Anesthesiologists Closed Claims Study database to define the role of nerve damage in the overall spectrum of anesthesia-related injury that leads to litigation. Of 1,541 claims reviewed, 227 (15%) were for anesthesia-related nerve injury. Ulnar neuropathy represented one-third of all nerve injuries and was the most frequent nerve injury. ⋯ The closed claims reviewers judged that the standard of care had been met significantly more often in claims involving nerve damage than in claims not involving nerve damage. The authors conclude that nerve damage is a significant source of anesthesia-related claims but that the exact mechanism of nerve injury is often unclear. In particular, ulnar nerve injuries seemed to occur without identifiable mechanism.
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Review Case Reports
Damage of the long thoracic and dorsal scapular nerve after traumatic shoulder dislocation: case report and review of the literature.
A judo injury resulted in an anterior shoulder dislocation with a concomitant lesion of the long thoracic and the dorsal scapula nerve. This injury led to loss of function and extreme instability of the shoulder. ⋯ The athlete declined further operative approaches to stabilize the scapula. The patient was able to return to the former level of athletic activity.
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Regional-Anaesthesie · Jan 1990
[Experimental studies on peripheral nerve injuries caused by injection needles].
Differences in neural damage due to different injection needles were investigated in vitro on sciatic nerve specimens of adult rabbits. METHODS. Three types of 22-gauge needles were tested: one typical, long-bevelled venous puncture needle; a short bevelled, typical nerve block needle; and a tapered, atraumatic spinal needle. ⋯ Fluorescence microscopy. With the tapered injection needle there was the least leakage of EBA, which suggests the least damage to the perineurium, and almost no rupture or tearing of the nerve fibers was observed. In the short- and long-bevelled needles, the damage was reduced when the face of the bevel was inserted parallel to the fibers.
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The state of the art in restoration of severed peripheral nerves is outlined. Discussion of the prerequisites for an optimal nerve-repair such as intraneural anatomy of peripheral nerves (topography of nerves in cross-section), techniques for preparation of nerve stumps, lesions in continuity, precise rotational orientation, nerve-suture, interfascicular dissection and nerve-grafting, including harvesting of autologous nerve grafts and finally the postoperative management after restoration of peripheral nerves are discussed.
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Schweiz. Rundsch. Med. Prax. · Oct 1989
Review[Palliative neurosurgical treatment of chronic pain following peripheral nerve lesions].
Pathogenesis of pain after traumatic or iatrogenic lesions to peripheral nerves as well as local and conservative therapeutic possibilities are briefly reviewed. If pain subsides or in the case of relapse with establishment of a chronic pain-state the therapy of choice consists in implanting a programmable neuro-stimulator with the electrodes placed near the dorsal sensory roots in the cervical epidural space for the upper extremities or along the posterior columns of the medulla in the thoracic epidural space for the legs. With a success rate for long term pain control of approximately 80% this reversible method which is well tolerated by the nervous system should always be considered for deafferentation-pain (neurogenic pain).