RESUMEN
INTRODUCTION: The prevalence of radial nerve injury during surgery is as high as the prevalence of radial nerve injury due to trauma. The aim of this study is to minimize the risk of iatrogenic injury of radial nerve. MATERIALS AND METHODS: Fifty patients with middle or distal diaphysis fractures of humerus and 18 patients with pseudoarthrosis at the same localizations were treated with surgery. Plate-screw fixation was performed with anterior approach in 43 patients. Eleven patients had minimally invasive plate osteosynthesis, and 14 patients had intramedullary nailing. The localization of the radial nerve was determined with nerve stimulator at the area of dissection. RESULTS: Iatrogenic radial nerve injury did not occur in patients treated with open reduction or minimally invasive approach. DISCUSSION: Nerve stimulator may be a method that decreases radial nerve injury, an iatrogenic complication. This method may be used in anterior approach and minimally invasive procedures.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas del Húmero/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Complicaciones Posoperatorias/prevención & control , Nervio Radial/lesiones , Neuropatía Radial/prevención & control , Estimulación Eléctrica Transcutánea del Nervio/instrumentación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Placas Óseas , Tornillos Óseos , Diseño de Equipo , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Nervio Radial/fisiopatología , Adulto JovenRESUMEN
STUDY DESIGN: A B design with subjects acting as their own control when the device is turned off. OBJECTIVE: Evaluation of the efficacy of the NeuroControl Freehand System. SETTING: A supra regional spinal unit in the UK. METHODS: The Freehand system is an implanted Functional Electrical Stimulation (FES) device for restoration of lateral and palmar grasps following C5 or C6 tetraplegia. Its use was assessed using the Grasp Relies Test (GRT), Activities of Daily Living (ADL), Grip strength and two-point discrimination. RESULTS: Seven out of nine subjects are currently daily users of the device. There were statistically significant increases in the number of types of task achieved and the number of repetitions of those tasks in the Grasp Release Test. The system produced a functionally strong grasp where no grip strength at all was possible prior to implantation. Three of the four subjects who had sensory ability prior to implant showed improvements in two-point discrimination. Most of the selected tasks were achieved in the ADL assessment indicating a significant improvement in independence. CONCLUSION: The Freehand system can significantly improve the functional ability of C5 and C6 lesion tetraplegics. SPONSORSHIP: This study was funded by the charity INSPIRE.