Rasulić Lukas, Đjurašković Slavko, Lakićević Novak, Lepić Milan, Savić Andrija, Grujić Jovan, Mićić Aleksa, Radojević Stefan, Córdoba-Mosqueda María Elena, Visani Jacopo, Puzović Vladimir, Kovačević Vojin, Vitošević Filip, Mandić-Rajčević Stefan, Knezevic Saša
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia.
Front Surg. 2022 Sep 20;9:942755. doi: 10.3389/fsurg.2022.942755. eCollection 2022.
Radial nerve lesions present a clinical entity that may lead to disability, psychological distress, and job loss, and thus requires great attention. Knowledge of the etiology and exact mechanism of the nerve impairment is of great importance for appropriate management of these patients, and there are only a few papers that focused on these features in patients with surgically treated radial nerve lesions. The lack of studies presenting the etiology and injury mechanisms of surgically treated radial nerve lesions may be due to a relatively small number of specialized referral centers, dispersion to low-flow centers, and a greater focus on the surgical treatment outcomes.
The aim of this study was to describe the etiological and epidemiological characteristics of patients with surgically treated radial nerve lesions of various origins.
This retrospective study evaluated 147 consecutive patients with radial nerve lesion, treated in the department during the last 20 years, from January 1, 2001, until December 31, 2020.
The majority of patients belonged to the working population, and 70.1% of them were male. Most commonly, the etiology of nerve lesion was trauma (63.3%) or iatrogenic injury (28.6%), while the less common origin was idiopathic (4.1%) or neoplastic (4.1%). The most frequent location of the lesion was in the upper arm, followed by the elbow and forearm. Fracture-related contusion was the most common mechanism (29.9%), followed by postoperative fibrosis (17.7%), lacerations (17.7%), and compression (15.6%).
Based on the fact that traumatic or iatrogenic injuries constitute the majority of cases, with their relevant mechanisms and upper arm predomination, it is crucial to raise awareness and understanding of the radial nerve injuries among orthopedic surgeons to decrease the numbers of these patients and properly preserve or treat them within the initial surgery.
桡神经损伤是一种可能导致残疾、心理困扰和失业的临床病症，因此需要高度关注。了解神经损伤的病因和确切机制对于这些患者的恰当管理至关重要，而仅有少数论文关注接受手术治疗的桡神经损伤患者的这些特征。缺乏关于接受手术治疗的桡神经损伤的病因和损伤机制的研究，可能是由于专门的转诊中心数量相对较少、患者分散到低流量中心，以及更侧重于手术治疗结果。
本研究的目的是描述接受手术治疗的各种病因的桡神经损伤患者的病因和流行病学特征。
这项回顾性研究评估了2001年1月1日至2020年12月31日期间在该科室接受治疗的147例连续的桡神经损伤患者。
大多数患者属于劳动人口，其中70.1%为男性。最常见的神经损伤病因是创伤（63.3%）或医源性损伤（28.6%），而较不常见的病因是特发性（4.1%）或肿瘤性（4.1%）。损伤最常见的部位在上臂，其次是肘部和前臂。骨折相关挫伤是最常见的机制（29.9%），其次是术后纤维化（17.7%）、撕裂伤（17.7%）和压迫（15.6%）。
基于创伤性或医源性损伤占大多数病例这一事实，以及它们的相关机制和以上臂为主的情况，提高骨科医生对桡神经损伤的认识和理解至关重要，以减少这类患者的数量，并在初次手术中妥善保护或治疗他们。
