Radtke C, Vogt P M
Klinik und Poliklinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland,
Unfallchirurg. 2014 Jun;117(6):539-55; quiz 556. doi: 10.1007/s00113-014-2574-7.
Peripheral nerve injuries are a common clinical problem and can represent a major challenge, especially after trauma. In order to achieve optimal therapy, an early and adequate diagnosis with subsequent therapy is critical for functional preservation and restoration. Especially after complete severance of a peripheral nerve, the surgical techniques for nerve coaptation are an important prerequisite for peripheral nerve regeneration. The importance and necessity of adequate nerve coaptation and nerve transplantation are presented in detail. In addition, the types of primary and secondary nerve reconstruction procedures are described as well as the optimal time point of nerve repair. This article provides a comprehensive overview of the possibilities for diagnosis and intervention after nerve injury, additionally including an algorithm for surgical intervention. Furthermore, possible pitfalls and factors for improving the functional outcome are presented to optimize results with trauma-related nerve injury.
周围神经损伤是常见的临床问题，可能构成重大挑战，尤其是在创伤后。为实现最佳治疗效果，早期且充分的诊断以及后续治疗对于功能的保留和恢复至关重要。特别是在周围神经完全离断后，神经吻合的外科技术是周围神经再生的重要前提。文中详细阐述了充分神经吻合和神经移植的重要性及必要性。此外，还描述了一期和二期神经重建手术的类型以及神经修复的最佳时间点。本文全面概述了神经损伤后诊断和干预的可能性，还包括手术干预的算法。此外，还介绍了可能存在的陷阱以及改善功能结果的因素，以优化创伤相关神经损伤的治疗效果。
