Use of ultrasound and targeted physiotherapy in the management of a nerve suture performed under joint flexion
| Autor: | Mariano Socolovsky, Rafael Barousse, Danilo Bataglia, Javier Robla-Costales |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Foot drop Neurosurgical Procedures 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Humans Medicine Range of Motion Articular Child Peroneal Neuropathies Physical Therapy Modalities Ultrasonography Neuroradiology Surgical repair medicine.diagnostic_test business.industry Ultrasound Peroneal Nerve Interventional radiology Recovery of Function Plastic Surgery Procedures Nerve injury Physical therapy Joint flexion Surgery Neurology (clinical) Neurosurgery medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Acta Neurochirurgica. 160:1597-1601 |
| ISSN: | 0942-0940 0001-6268 |
| Popis: | In 1915, when Delorme described three general requirements for successful nerve repair—(1) resecting scar until a healthy bed is secured, (2) excising damaged nerve until healthy stumps are reached, and (3) placing tension-free sutures, either by adequately mobilizing adjacent joints or nerve grafting—his work was heavily criticized. One century later, history has vindicated all but one of these claims. Flexing adjacent joints to avoid nerve grafts remains controversial, though this practice has increased in recent years. An 11-year-old male suffered a penetrating domestic accident that resulted in complete foot drop. At surgery, a 6-cm gap was treated with direct nerve sutures, for which the knee was maintained in 60° flexion in a cast. To avoid damage to the nerve sutures, ultrasound and an intense, though cautious physiotherapy program were employed to guide the progression of knee extension. The patient started to show clear signs of peroneal motor function recovery within 3 months of surgical repair, and almost complete recovery by 4 months postoperatively. Using physiotherapy and ultrasound might validate the classic joint-flexion technique in select patients with lower-limb nerve injuries. |
| Databáze: | OpenAIRE |
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