tailieunhanh - Nách thần kinh chấn thương: Chẩn đoán và điều trị

Nách chấn thương thần kinh là không thường xuyên được chẩn đoán nhưng không phải là hiếm khi xảy ra. Tổn thương thần kinh có thể là kết quả của một lực lượng lực kéo hoặc chấn thương cùn áp dụng cho vai. Khu vực phổ biến nhất của chấn thương chỉ là gần với không gian tứ giác. | Axillary Nerve Injury Diagnosis and Treatment Scott P. Steinmann MD and Elizabeth A. Moran MD Abstract Axillary nerve injury is infrequently diagnosed but is not a rare occurrence. Injury to the nerve may result from a traction force or blunt trauma applied to the shoulder. The most common zone of injury is just proximal to the quadrilateral space. Atraumatic causes of neuropathy include brachial neuritis and quadrilateral space syndrome. The vast majority of patients recover with nonoperative treatment. Baseline electromyographic and nerve conduction studies should be obtained within 4 weeks after injury with a follow-up evaluation at 12 weeks. If no clinical or electromyographic improvement is noted surgery may be appropriate. The results of operative repair are best if surgery is performed within 3 to 6 months from the injury. Surgical options include neurolysis nerve grafting and neurotization. The results of repair of axillary nerve injuries have been good compared with treatment of other peripheral nerve lesions due to the monofascicular composition of the nerve and the relatively short distance between the zone of injury and the motor end-plate. J Am Acad Orthop Surg 2001 9 328-335 Axillary nerve lesions are not commonly diagnosed. Although most such injuries respond to nonoperative measures surgical treatment is warranted in selected cases. With advances in microsurgery increased awareness of the potential for treatment of brachial plexus injuries and the greater focus on shoulder disorders in the past decade complex reconstructive procedures on the shoulder are now more common. Accurate knowledge of axillary nerve anatomy and function is paramount to avoid complications after such procedures. Several reports on the results of surgical treatment of axillary nerve lesions have been A thorough understanding of the etiology diagnosis and treatment of axillary nerve lesions not only aids in the avoidance of injury to the nerve during surgical .