Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Neurosurg Focus. 2010 May;28(5):E24. doi: 10.3171/2010.3.FOCUS103.
Although the clinical and electrical diagnoses and treatments of peripheral nerve injuries (PNIs) had been described prior to World War I, many reports were fragmented and incomplete. Individual physicians' experiences were not extensive, and in 1914 the patient with a PNI remained a subject of medical curiosity, and was hardly a focus of comprehensive care. World War I altered these conditions; casualties with septic wounds and PNIs swamped the general hospitals. By 1915, specialized hospitals or wards were developed to care for neurological injuries. In the United Kingdom, Sir Robert Jones developed the concept of Military Orthopedic Centres, with coordinated specialized care and rehabilitation. Military appointments of neurologists and electrotherapists sharpened clinical diagnoses and examinations. Surgical techniques were introduced, then discarded or accepted as surgeons developed skills to meet the new conditions. The US Surgeon General, William Gorgas, and his consultant in neurosurgery, Charles Frazier, went a step further, with the organization of a research laboratory as well as the establishment of a Peripheral Nerve Commission and Registry. Despite these developments and good intentions, postwar follow-up for PNIs remained incomplete at best. Records were lost, personnel transferred, and patients discharged from the system. The lack of a standardized grading system seriously impaired the ability to record clinical changes and compare outcomes. Nevertheless, specialized treatment of a large number of PNIs during World War I established a foundation for comprehensive care that influenced military medical services in the next world war.
尽管在第一次世界大战之前就已经描述了周围神经损伤（PNI）的临床和电诊断和治疗，但许多报告都是零散和不完整的。个别医生的经验并不丰富，1914 年，患有 PNI 的患者仍然是医学好奇心的对象，几乎不是全面护理的焦点。第一次世界大战改变了这些情况；患有脓毒性伤口和 PNI 的伤员使综合医院人满为患。到 1915 年，专门的医院或病房已经发展起来，以照顾神经损伤。在英国，罗伯特·琼斯爵士（Sir Robert Jones）提出了军事骨科中心的概念，提供协调的专业护理和康复服务。神经病学家和电疗师的军事任命使临床诊断和检查更加敏锐。外科技术被引入，然后被丢弃或被接受，因为外科医生发展技能以满足新的条件。美国外科医生总干事威廉·加加斯（William Gorgas）和他的神经外科顾问查尔斯·弗雷泽（Charles Frazier）更进一步，成立了一个研究实验室，以及建立了一个周围神经委员会和登记处。尽管有这些发展和良好的意愿，但 PNI 的战后随访充其量也只是不完整的。记录丢失，人员调动，患者从系统中出院。缺乏标准化的分级系统严重影响了记录临床变化和比较结果的能力。尽管如此，第一次世界大战期间对大量 PNI 的专门治疗为全面护理奠定了基础，这对下一次世界大战的军事医疗服务产生了影响。
