Fractures and Joint Injuries
Louis Solomon, David Warwick, Selvadurai Nayagam in Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Injured tissues must be handled gently. To try and elicit crepitus or abnormal movement is unnecessarily painful; in any case, x-ray diagnosis is more reliable. Nevertheless, a systematic approach is essential, or damage to arteries, nerves, ligaments and viscera may be overlooked: Examine the most obviously injured part.Check for arterial damage.Test for nerve injury.Look for injuries of local soft tissues and viscera.Look for injuries in distant parts.
The Triple Heater (TH)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Several orthopedic surgical procedures put the axillary nerve at risk.6 Iatrogenic injury can occur following shoulder arthroscopy, thermal shrinkage of the shoulder, and plate fixation of the proximal humerus. The caudal branch of the axillary nerve associates closely with distal aspects of the glenoid and shoulder joint capsule.7 This is where the nerve can suffer damage during capsular plication or thermal shrinkage. The superior lateral brachial cutaneous nerve arises from this caudal, or posterior, branch. The caudal deltoid more often receives innervation from the anterior or cranial branch of the axillary nerve, which may lead to injury during a posterior deltoid-splitting approach to the shoulder. In cases of nerve injury at or around TH 14, consider acupuncture and related techniques to revitalize the nerve(s) and accelerate soft tissue healing and return of function.
Complications of Anesthesia
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
Anesthesia-related nerve injury accounted for 16% (4183 claims) of the claims in a 1999 analysis of the ASA Closed Claims Project database [32]. The most common nerve injury among these cases was the ulnar nerve (28%), followed by the brachial plexus (20%), and lumbosacral nerve roots (16%). Nerve injury can be secondary to pressure, stretch, ischemia, toxins, direct trauma, or other undetermined causes. Ulnar nerve and brachial plexus injury are more commonly seen in cases of general anesthesia, while lumbosacral root injury is associated with regional technique [32].
Transplantation of microencapsulated olfactory ensheathing cells inhibits the P2X2 receptor over-expressionmediated neuropathic pain in the L4–5 spinal cord segment
Published in International Journal of Neuroscience, 2020
Wen-Jun Zhang, Jian Xu, Mei-Juan Xiong, Zeng-Xu Liu, Zheng-Ming Zhu
Nerve injury can induce some disorders in the motor and sensory functions in the body, especially produce a certain levels of pain [20]. However, the repair ability following a nerve injury is limited. P2X purine receptors play a critical role in the developmental of NPP induced by nerve damage. Previous research have shown that the P2X2R is expressed at high levels after nerve injury, and that the P2X2R expression levels directly related to the degree of nerve injury [7,21]. At present, cell transplantation occupies an important position in many aspects of research and treatment of NPP. OECs was regarded as the most ideal therapy candidate cell due to the characteristics of self-renewal and survival lifetime in the nervous system, it can release a variety of neurotrophic factors, promote the regeneration of axons, and repair the damaged nerves [22]. Microcapsulation have the characteristics of a biological semipermeable membrane, have the function of immune isolation, reduce transplanted cell damage in the host, and improve survival [22]. Our previous study have shown that MC-OECs transplantation can inhibit pain by reducing the over-expression of P2X2/3 receptor in the dorsal root ganglion [16].
Differential diagnosis of knee pain following a surgically induced lumbosacral plexus stretch injury. A case report
Published in Physiotherapy Theory and Practice, 2019
William R. VanWye, Harvey W. Wallmann, Elizabeth S. Norris, Karen E. Furgal
Numerous diseases, injuries, and impairments can alter LE biomechanics. For example, LE tendinopathies, bursitis, ligamentous instabilities, internal derangements, muscle imbalances, or intraarticular pathologies are just a few of the pathologies and disorders that could result in biomechanical disorders PTs face on a daily basis. Another such pathology that may result in altered LE biomechanics is weakness due to a peripheral nerve injury. Mechanisms of peripheral nerve injury include ischemia, vibration, electric shock, radiation, thermal, or more commonly, a laceration, compression, or stretch injury (Campbell, 2008). Trauma-related upper and LE peripheral nerve injuries have an incidence of 2.8% with 17% of the cases being iatrogenic in nature (Noble, Munro, Prasad, and Midha, 1998). Iatrogenic causes are typically associated with surgical factors, such as direct trauma, tourniquet pressure, casting, or radiation (Antoniadis et al, 2014). In addition, surgical positioning can compress or stretch nerves, resulting in ischemia (Barnett et al, 2007).
Evaluation of dexamethasone treated mesenchymal stem cells for recovery in neurotmesis model of peripheral nerve injury
Published in Neurological Research, 2018
Mehrnaz Moattari, Farahnaz Moattari, Gholamreza Kaka, Homa Mohseni Kouchesfehani, Seyed Homayoon Sadraie, Majid Naghdi, Korosh Mansouri
Nerve injury is very common clinically due to accidents and injuries. It is mentioned that peripheral nervous system has the ability to repair because myelin debries clear in the site of injury [3]. Reconstructive microsurgery is the key strategy among the various methods that have improved the world of peripheral nerve tissue engineering over the recent years. Yet, the surgeon should improve the design of the basic science experiments in order to help the whole process of research and development. A combinational therapy is preferred. Definitely, the search for new peripheral nerve substitutes is one of the topics that have achieved the most attention in the field of peripheral nerve repair and regeneration research. Regenerative medicine and tissue engineering will develop the improvement of the optimized combination of many different methodologies [19]. Transected peripheral nerves can regenerate provided that a connection is available between the proximal and distal severed stumps and, when no substance loss occurred, surgical treatment consists in direct end-to-end suturing of the nerve ends. The procedure of careful alignment of the most severe axonal damage and tight re-apposition of axonal halves took about a minute to morphologically reconnect the severed axonal segments by epineurium suturing with 7/0 Prolene sutures. However, the association of cut ends might not need to be completely fixed to yield some behavioral recovery since nearby axons in mammals often have very similar receptive fields or innervate similar target cells [3].
Related Knowledge Centers
- Central Nervous System
- Glia
- Nervous Tissue
- Reinnervation
- Wallerian Degeneration
- Connective Tissue
- Injury
- Peripheral Nerve Injury Classification
- Nerve
- Neuroregeneration