Missile-induced complete lesions of the tibial nerve and tibial division of the sciatic nerve: results of 119 repairs.
J Neurosurg
; 103(4): 622-9, 2005 Oct.
Article
en En
| MEDLINE
| ID: mdl-16266043
ABSTRACT
OBJECT Very few extensive studies regarding the repair of missile-induced tibial nerve or tibial division complete lesions have been published to date. In this prospective study, the outcomes of such repairs as well as factors influencing them are presented. METHODS:
Between 1991 and 1994, 119 patients with missile-induced complete lesions of the tibial nerve or tibial division were treated in the neurosurgical department of the Military Medical Academy, Belgrade. After at least 4 years of follow up, the final outcome was defined as poor, insufficient, good, or excellent, based on sensorimotor recovery, electromyoneurography-demonstrated recovery, and patient judgment. Good and excellent outcomes were considered to be successful. The influence of the repair level, length of the defect, and preoperative interval on final outcome was also tested. A successful outcome was obtained in 30.3% of high-level, 50% of intermediate-level, and 85.7% of low-level repairs (p < 0.001). On average, the nerve defect and preoperative interval were significantly shorter in patients with a successful outcome. Significant worsening of the outcome was related to a nerve defect longer than 5 cm and a preoperative interval longer than 4 months. Repair level, preoperative interval, and length of the defect were independent predictors of a successful outcome.CONCLUSIONS:
A successful outcome is most probable following the low-level repairs, within the first 4 months after injury, and using grafts shorter than 5 cm. Other repairs can also be beneficial in preventing dangerous anesthesia of the sole of the foot and enabling almost normal walking.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Nervio Ciático
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Nervio Tibial
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Heridas por Arma de Fuego
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Procedimientos Neuroquirúrgicos
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Medicina Militar
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Neurosurg
Año:
2005
Tipo del documento:
Article