الفهرس | Only 14 pages are availabe for public view |
Abstract Microanatomy of the peripheral nerves consists of axons of neurons whose cell bodies are located either in the spinal cord (anterior horn cells) or in the dorsal root ganglia. The axons within nerve trunk are arranged in fascicles by means of connective tissue. The diagnosis of peripheral nerve injury is done by means of the medical history and neurological examination. Imaging studies such as plain X ray, Computed tomography and Magnetic resonance imaging together with electrodiagnostic studies (which include electromyography and nerve conduction velocity) are essentially useful. Traumatic peripheral nerve lesions can be classified according to their severity into neuropraxia, neurotmesis and axonotmesis. In neuropraxia no surgical intervention is needed and the patient has to be followed up. If it is axonotmesis or neurotmesis then the patient may be in need for surgical intervention either early or late. from this work it is concluded that; -The timing of nerve repair depends very much on available facilities as well as the experience of the surgeon, but in general, if there is an open injury with a clean sharp nerve transection, immediate repair can be done. But if there is an open injury with a blunt nerve transection then delayed nerve exploration is indicated after repair and/or healing of other wounded tissues. On the other hand, if there is a closed injury follow up by clinical assessment and electrophysiological studies is indicated 3 months and if there is failure of recovery then surgical exploration is indicated. -The type of nerve repair could be neurolysis if the nerve is in continuity and not damaged, but, if the nerve is severely damaged and no action potential could be elicited across the site of injury, resection of the affected part is done together with anastomosing the two nerve stumps either directly or through any suitable nerve conduits. |