Articles: peripheral-nerve-injuries.
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Neurosurg. Clin. N. Am. · Jan 1991
ReviewAspects on pathophysiology of nerve entrapments and nerve compression injuries.
The microanatomy of the neuron and the peripheral nerve, which is a composite tissue, should be considered when discussing the pathophysiology of nerve compression injuries. Acute and chronic compression of peripheral nerve can induce changes in intraneural microcirculation and nerve fiber structure, increase vascular permeability with subsequent edema formation, and impair anterograde and retrograde axonal transport, which all contribute to the clinical symptoms and deterioration of nerve function. ⋯ Diabetes mellitus may confer on the peripheral nerve an increased susceptibility to compression injuries. Clinical stages of compression syndromes, such as carpal tunnel syndrome, may be related to specific pathophysiologic events occurring in the nerve.
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Acta Orthop Scand Suppl · Jan 1991
ReviewTourniquet-induced neuromuscular injury. A recent review of rabbit and clinical experiments.
A rabbit model was developed which facilitates controlled, experimental studies of tissue injury beneath and distal to a pneumatic tourniquet. Non-uniform tissue deformation was observed beneath inflated tourniquets; such patterns were not predicted by previous mathematical models. Two hours was a time threshold for tourniquet compression injury; depending upon the cuff inflation pressure, greater muscle injury was induced beneath the tourniquet than distal to it. ⋯ In conclusion, tourniquet application, at clinically relevant cuff inflation pressures and durations, induces greater neuromuscular injury beneath the tourniquet than distal to it. Investigators of systemic effects of limb ischemia should be aware of compression injury induced by pneumatic tourniquet models. Surgeons must weigh the advantages of a bloodless field against the disadvantages of tourniquet-induced neuromuscular injury.
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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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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.