Vrebalov-Cindro V, Reic P, Ognjenovic M, Jankovic S, Andelinovic S, Karelovic D, Kapural L, Rakic M, Primorac D
Department of Neurology, University Hospital, Split, Croatia.
Mil Med. 1999 May;164(5):351-2.
The purpose of this study is to evaluate peripheral nerve war injuries sustained during the war in southern Croatia and Bosnia and Herzegovina.
During the war in Croatia, 713 patients (99% male and 1% female) with wounds inflicted by firearms were examined at the Laboratory of Neurophysiology, University Hospital, Split. The patients, soldiers and civilians alike, ranged in age from 6 to 73 years (average, 28 years). All patients with firearm nerve war injuries underwent detection by electromyography and plurisegmental examination of the damaged peripheral nerve (neurography). The patients were examined and controlled on three occasions: within 2 months after wounding; up to 6 months after wounding; and more than 6 months after wounding.
Single peripheral nerve lesions were present in 80% of the patients, and multiple peripheral nerve or plexus lesions were present in 20% of the patients. Peroneal and ulnar nerves were most often involved (20.9% and 19.8%, respectively). Associated massive injuries to the muscles, large blood vessels, or vital organs were present in 45% of the patients. Wounds were inflicted by shell fragments in 80% of the patients and by projectiles in 20% of the patients.
According to our results, better recovery was achieved with conservative treatment and when physical therapy was initiated early with maximal patient cooperation. Electromyoneurographic findings were the most valid in the prognostic classification of war-inflicted peripheral nerve injuries.
本研究旨在评估在克罗地亚南部及波斯尼亚和黑塞哥维那战争期间所遭受的周围神经战伤情况。
在克罗地亚战争期间，713例受火器伤的患者（99%为男性，1%为女性）在斯普利特大学医院神经生理学实验室接受检查。这些患者包括士兵和平民，年龄在6岁至73岁之间（平均28岁）。所有火器所致周围神经战伤患者均接受了肌电图检测以及受损周围神经的多节段检查（神经造影）。对患者进行了三次检查及随访：受伤后2个月内；受伤后6个月内；受伤后6个月以上。
80%的患者存在单条周围神经损伤，20%的患者存在多条周围神经或神经丛损伤。腓总神经和尺神经最常受累（分别为20.9%和19.8%）。45%的患者伴有肌肉、大血管或重要器官的严重损伤。80%的患者伤口由弹片造成，20%的患者伤口由子弹造成。
根据我们的结果，在保守治疗且患者最大程度配合并早期开始物理治疗的情况下，恢复情况更佳。肌电图神经图检查结果在战伤所致周围神经损伤的预后分类中最为有效。
