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17- EVALUATION OF PERIPHERAL NERVE INJURIES AROUND ELBOW IN ASSOCIATION WITH FRACTURES

Ali Hamzaa --- Alaa A Dawood

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2011 Volume: 17 Issue: 1 Pages: 119
Publisher: Basrah University جامعة البصرة

Abstract

Alaa A Dawood# & Ali Hamzaa*#MB,ChB, FICMS, Orthopaedic Surgeon, Lecturer, Dept. Of Surgery, College of Medicine, University ofBasrah. *MB,ChB, Orthopaedic Surgeon, Basrah General Hospital, Basrah, IRAQ.AbstractIn this prospective study, 147 cases of trauma around elbow were examined and evaluated. Allwere unilateral. Only 22 were associated with peripheral nerve injuries (14.9%). Males were 19(86%) and females were 3 (14%). Their ages were between 5 and 54 years (mean 24 years).The radial nerve was found to be most vulnerable to injury (40.9%) followed by ulnar nerve(31.8%) and lastly the median nerve (9.1%).The injurious agents in 2 patients were bullet and missile while in 20 were civilian causes.In thirteen cases (59.1%) there were primary nerve palsy and in 9 (40.9%) there weresecondary nerve palsies.The degree of nerve injury in 13 patients were neuropraxia (59.1%) with complete recovery, in6 were neurotmesis (27.3%) and in 3 were axonotmesis (13.6%).The full recovery of the nerve was in 13 patients (59.1%), 12 of them by spontaneous recovery(54.5%) and one of them by surgical exploration and neurolysis (4.5%).Timing of nerve recoverywere variable, range from 1.5 to 8 months. There was no recovery in 9 patients (40.9%).We concluded that when closed fractures are complicated by primary nerve deficits, waiting forspontaneous re-innervation seems reasonable up to eight months and early surgical explorationis better to be avoided, conversely if closed fracture complicated by secondary nerve palsy earlyexploration of nerve is favored except in Tourniquet palsies.

Keywords

PERIPHERAL NERVE --- ELBOW --- FRACTURES