Grigorovich K A
Vestn Khir Im I I Grek. 1976 Jul;11(7):128-32.
The experience with 1896 restorative operations on injured nerve trunks shows a necessity to consider the problems of diagnosis, prognosis and choice of the treatment, and especially the results of the nerve suture, not in all patients with nerve injury but only in separate groups being comparable with respect to the kind and severity of the trauma. The probability of spontaneous recovery after cut and prick wounds is very small, if the signs of complete interruption of the conductivity are revealed from the very beginning. As a rule, nerve suture seems to be indicated after establishing the precise diagnosis. Rush and inadequate operations in primary surgical treatment of the wound, in particular, can cause an additional and severe trauma of the nerve, which repairing proves to be difficult and sometimes even impossible. In bone fractures the operation on injured nerves may be indicated after establishing the precise diagnosis during the period of "justified wating", taking into account the injury level and details of the clinical course. In traction lesions of the brachial plexus the correct diagnosis of the level and severity of the trauma must be established without an operation.
对1896例损伤神经干的修复手术的经验表明,有必要考虑诊断、预后和治疗选择的问题,特别是神经缝合的结果,并非对所有神经损伤患者都要考虑,而仅针对那些在创伤类型和严重程度方面具有可比性的不同组别。如果从一开始就显示出传导完全中断的迹象,切割伤和刺伤后自发恢复的可能性非常小。通常,在做出准确诊断后似乎需要进行神经缝合。特别是在伤口的一期外科治疗中匆忙且不充分的手术,可能会对神经造成额外的严重创伤,事实证明这种创伤修复起来很困难,有时甚至不可能。在骨折中,考虑到损伤水平和临床过程的细节,在“合理等待”期间做出准确诊断后,可能需要对损伤的神经进行手术。在臂丛神经牵拉伤中,必须在不进行手术的情况下正确诊断创伤的水平和严重程度。