By Andrzej M. Tomczyk
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An interesting experimental technique involves the use of strips of muscle as a nerve graft. Tinel’s sign This is a useful sign for following recovery. Gentle tapping with the fingertip along the course of the nerve will result in the patient feeling pins and needles in the distribution of the nerve when the point of regeneration is reached. This point 22 Brachial plexus injuries These produce complex neurological pictures. Some common patterns can be discerned. Birth injuries These are now rare and usually occur as a result of traction or pressure during delivery.
Presence or absence of the pulses is not, however, a good guide to the diagnosis. Treatment The most important aspect of management is an awareness that the condition may develop. If any of the above features appear, the condition should be suspected. It is possible to measure the intracompartmental pressures using a simple manometric device and pressures within 30 mmHg of the diastolic blood pressure are usually regarded as an indication for decompression. This is carried out by splitting the deep fascia over the length of the compartment (fasciotomy).
Treatment Those cases developing during pregnancy often settle after delivery. A trial of a plaster back-slab to immobilize the wrist is often useful. An injection of a steroid preparation into the carpal tunnel is often helpful, but persistent cases can be relieved quickly by operative decompression of the carpal tunnel, although muscle wasting may be permanent. Acute peripheral nerve injuries Lecture Notes: Orthopaedics and Fractures, 4e. By T Duckworth and CM Blundell. Published 2010 by Blackwell Publishing.
Japonska Bron Pancerna - Japanese Armor by Andrzej M. Tomczyk