|
KMID : 0378019770200080044
|
|
New Medical Journal
1977 Volume.20 No. 8 p.44 ~ p.48
|
|
|
Peripheral Nerve Injury of the Upper Extremity by the High Velocity Projectile
|
|
|
|
|
Abstract
|
|
|
Both low and high velocity projectiles which either directly or indirectly damage the nerve cause not only severe injury in the path of the wound but -will extend several centimeters.
This type of trauma can also cause gross destruction of nerves and other tissues, which lead to scarring thus a poor bed for, the during its repair.
This paper emphasizes that the high velocity injury even though the nerve has its continuity, a burning and/or concussion may cause severe destruction of its sheath and cell mass. Even though nerve has retained its continuity it should be explored if it dose not return to normal function within an expected time. An end-to-end anastomosis or nerve graft should be done after complete resection of damaged nerve segment.
This paper examine 87 cases of nerve damage due to gun shot wound with result as follow; A) Nerve with continuity;
35 cases (40.2%) which included 11 median nerve, 12 ulnar n., 9 radial n., mixed nerve injury median and ulnar were 3 cases.
B) Nerve without continuity;
52 cases (59.8%) which included 16 median nerve, 17 ulnar n., 14 radial n., mixed injury median and ulnar were 5 cases.
Mixed nerve injury median and ulnar n. 1 case in the upper arm, and 7 cases in the forearm. The time for spontaneous recovery of the upper arm injuries were average 5 weeks in the musculocutaneous n., 8 weeks (4-9 wks) for the radial n., 10 weeks (6-12 wks) for the median n., and 12 weeks (8-18 wks) for the ulnar n..
Pathological changes of the damaged nerve observed by light and electron microscope which
showed blistering and edematous swelling 1.5 cm at both proximal and distal portion.
Nerve injury by indirect effect revealed degeneration of the nerve tissue and occlusion of the
vaso nervorum 1.2 cm in length.
This study indicates that in both severed or unsevered nerve resulting from gun shot wound we should wait for specific period of time prior to surgical repair to receive maximum functioning of the extremity.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|