Traumatic nerve injuries
What is it?
Peripheral nerve injuries are often caused by cutting objects (e.g. glass, knife, bone splinters, scalpel) or other objects that compress or stretch the nerves.
In the first case, the injury occurs rather quickly, whereas in the case of compression (e.g., when using an inappropriate plaster cast), the effect is slower and more gradual.
Often the injury causes collateral damage, especially to the skeleton, which can aggravate nerve damage.
There are certain factors that aggravate the severity of nerve injury; for example, the close proximity of certain nerves to certain bony structures may result in direct compression of the nerve by a bony structure or its damage by bone debris.
On the other hand, some nerve structures (such as the brachial nerve plexus above and below the collarbone) are not very mobile due to anatomical features and are therefore more susceptible to injury from sudden stretching.
Which are the symptoms?
Patients may have both sensory disturbances and lack of strength, varying depending on the injured nerve.
How is it diagnosed?
Clinical and instrumental diagnosis using both radiological (ultrasound, conventional radiography, computed and magnetic resonance imaging) and electrophysiological (e.g., electromyography) methods are carried out.
Suggested exams
How is it treated?
En general, se distingue entre traumas abiertos y cerrados.
En los primeros, hay una exposición directa del nervio por laceración de los tejidos que lo recubren. En estos casos, sobre todo en el caso de las lesiones cortantes, es aconsejable intervenir quirúrgicamente en una fase temprana suturando los dos muñones nerviosos.
Por el contrario, los traumatismos cerrados suelen estar causados por un mecanismo de contusión o estiramiento y no hay una exposición directa del nervio. En estos casos, es aconsejable posponer la cirugía hasta 60 días, durante los cuales el paciente debe someterse a una serie de controles clínicos y electrofisiológicos (por ejemplo, electromiografía) para verificar si hay una recuperación espontánea de la función nerviosa.
El tiempo de hospitalización puede ser de unos pocos días, como en el caso de un traumatismo nervioso solo, o más largo si también hay daños traumáticos graves en otros órganos.
Where do we treat it?
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