Детская хирургия. Журнал им. Ю.Ф. Исакова. 2023; 27: 210-212
Мнение экспертов к статье Говенько Ф.С., Снищук В.П., Климкин А.В., Малецкий Э.Ю. «Закрытые повреждения срединного нерва у детей: тактика, варианты операции»
https://doi.org/10.55308/1560-9510-2023-27-3-210-212Аннотация
Переломы костей верхних конечностей занимают одно из первых мест в травме детского возраста. Одним из грозных осложнений этой травмы являются повреждения кровеносных сосудов и нервов. Наиболее часто из них встречающиеся – это закрытые повреждения нервных стволов. В источниках литературы достаточно подробно описаны частота и различные риск-факторы повреждения нервов, но все эти публикации носят разрозненный характер. До сих пор не существует аргументированного алгоритма ведения пациентов с закрытыми повреждениями нервных стволов. Выбор тактики лечения в пользу консервативной или хирургической также сводится к мнению отдельных авторов. Несмотря на то, что большинство закрытых повреждений нервов восстанавливаются спонтанно, существует процент пациентов, которым необходимо своевременное хирургическое вмешательство. Результаты диагностических мероприятий, таких как электронейромиография, не всегда правильно трактуются клиницистами и лишь опосредованно влияют на сроки оперативного вмешательства. В нашем обсуждении мы решили подробнее раскрыть эту тему.
Список литературы
1. Cheng J.C.Y., Lam T.P., Shen W.Y. Closed reduction and percutaneous pinning for type III displaced supracondylar fractures of the humerus in children. J Orthop Trauma. 1995; 9: 511– 5.
2. Farnsworth C.L., Silva P.D., Mubarak S.J. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998; 18: 38–42.
3. Mubarak S.J., Davids J.R. Closed reduction and percutaneous pinning of supracondylar fractures of the distal humerus in the child. In: Morrey B.F., ed. The elbow. New York: Raven Press. 1994: 37–51.
4. Wilkins K.E., ed. Operative management of upper extremity fractures in children. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1994: 75–86
5. Brown I.C., Zinar D.M. Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children. J Pediatr Orthop. 1995; 15: 440–3.
6. Culp R.W., Osterman A.L., Davidson R.S., et al. Neural injuries associated with supracondylar fractures of the humerus in children. J Bone Joint Surg. 1990; 72A: 1211–5.
7. Hennrikus W.L., O’Brien T., Champa J., et al. Neurologic complications stemming from displaced supracondylar fractures and from the treatment of these fractures in children. Orthop Trans. 1993; 16: 818.
8. Pirone A.M., Graham H.K., Krajbich J.I. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg. 1988; 70A: 641–9.
9. Iobst C.A., Spurdle C., King W.F., et al. Percutaneous pinning of pediatric supracondylar humerus fractures with the semisterile technique: the Miami experience. J Pediatr Orthop. 2007; 27: 17–22.
10. Campbell C.C., Waters P.M., Emans J.B., et al. Neurovascular injury and displacement in type III supracondylar humerus fractures. J Pediatr Orthop. 1995;15: 47–52.
11. Salem-Saqer Khaled. Studies in carpal tunnel syndrome and cold intolerance. DM thesis, University of Nottingham Carpal tunnel syndrome, Ron Gorsché. The Canadian Journal of CME. October 2008. https://eprints.nottingham.ac.uk/id/eprint/10491
12. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951 Dec; 74(4): 491–516. https://doi.org/10.1093/brain/74.4.491
Russian Journal of Pediatric Surgery. 2023; 27: 210-212
Expert opinion on the article Govenko F.S., Snischuk V.P., Klimkin A.V., Maletsky E.Yu. "Closed injuries of the median nerve in children: tactics, variants of surgery"
https://doi.org/10.55308/1560-9510-2023-27-3-210-212Abstract
Bone fractures in the upper extremities occupy one of the first places in the structure of pediatric trauma. One of the serious complications after such injury is damage to blood vessels and nerves. Closed injury of nerve trunks is most common. The rate of nerve damage and various risk factors are sufficiently described in literary sources; however, these publications are uncoordinated. Up to now, there is no any reasonable algorithm for managing patients with closed injuries of nerve trunks. The choice of curative tactics – conservative or surgical – depends on the opinion of individual author. Though most closed nerve injuries recover spontaneously, there is a percentage of cases when a timely surgical intervention is a must. Diagnostic findings, such as after electroneuromyography (ENMG), are not always correctly interpreted by clinicians and only indirectly determine the time of surgical intervention. In our discussion, we have decided to develop this topic in more details.
References
1. Cheng J.C.Y., Lam T.P., Shen W.Y. Closed reduction and percutaneous pinning for type III displaced supracondylar fractures of the humerus in children. J Orthop Trauma. 1995; 9: 511– 5.
2. Farnsworth C.L., Silva P.D., Mubarak S.J. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998; 18: 38–42.
3. Mubarak S.J., Davids J.R. Closed reduction and percutaneous pinning of supracondylar fractures of the distal humerus in the child. In: Morrey B.F., ed. The elbow. New York: Raven Press. 1994: 37–51.
4. Wilkins K.E., ed. Operative management of upper extremity fractures in children. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1994: 75–86
5. Brown I.C., Zinar D.M. Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children. J Pediatr Orthop. 1995; 15: 440–3.
6. Culp R.W., Osterman A.L., Davidson R.S., et al. Neural injuries associated with supracondylar fractures of the humerus in children. J Bone Joint Surg. 1990; 72A: 1211–5.
7. Hennrikus W.L., O’Brien T., Champa J., et al. Neurologic complications stemming from displaced supracondylar fractures and from the treatment of these fractures in children. Orthop Trans. 1993; 16: 818.
8. Pirone A.M., Graham H.K., Krajbich J.I. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg. 1988; 70A: 641–9.
9. Iobst C.A., Spurdle C., King W.F., et al. Percutaneous pinning of pediatric supracondylar humerus fractures with the semisterile technique: the Miami experience. J Pediatr Orthop. 2007; 27: 17–22.
10. Campbell C.C., Waters P.M., Emans J.B., et al. Neurovascular injury and displacement in type III supracondylar humerus fractures. J Pediatr Orthop. 1995;15: 47–52.
11. Salem-Saqer Khaled. Studies in carpal tunnel syndrome and cold intolerance. DM thesis, University of Nottingham Carpal tunnel syndrome, Ron Gorsché. The Canadian Journal of CME. October 2008. https://eprints.nottingham.ac.uk/id/eprint/10491
12. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951 Dec; 74(4): 491–516. https://doi.org/10.1093/brain/74.4.491
