Neubauer T, Brand J, Hartmann A
Unfallchirurgische Abteilung, Landesklinikum Horn, Spitalgasse 10, 3580, Horn, Österreich.
Unfallchirurgische Abteilung, Landeskrankenhaus Salzburg, Paracelsus Medizinische Universität, Salzburg, Österreich.
Unfallchirurg. 2020 Mar;123(3):225-237. doi: 10.1007/s00113-020-00768-9.
Lesions of peripheral nerves substantially influence the long-term prognosis and functional outcome. Approximately 70% of peripheral nerval lesions are associated with vascular injuries and occur more frequently with certain fractures and osteosynthesis types. The prognosis and treatment depend on the severity of the injury and the presence of axonal lesions, in particular, determines the further procedure. Treatment as early as possible is associated with a clear improvement in the prognosis. Defects longer than 8 mm in size necessitate a nerve transplantation. Iatrogenic vascular lesions occur particularly in percutaneous interventions and are reported in up to 8% of cases after operations involving the musculoskeletal system. Iatrogenic nerve lesions are almost exclusively the result of surgical procedures and represent up to 17.5% of traumatic nerve injuries. For all lesions the general principles of surgical treatment are valid and the rapid involvement of professional expertise is decisive.
周围神经损伤严重影响长期预后和功能结局。约70%的周围神经损伤与血管损伤相关,且在某些骨折和骨固定类型中更常见。预后和治疗取决于损伤的严重程度,特别是轴突损伤的存在决定了后续的治疗方案。尽早治疗与预后的明显改善相关。长度超过8毫米的缺损需要进行神经移植。医源性血管损伤尤其发生在经皮介入操作中,在涉及肌肉骨骼系统的手术后,高达8%的病例有相关报道。医源性神经损伤几乎完全是手术操作的结果,占创伤性神经损伤的比例高达17.5%。对于所有损伤,手术治疗的一般原则都是适用的,迅速获得专业知识至关重要。