Nerve trunk rupture

Introduction V-degree nerve injury, that is, nerve stem rupture, the nerve bundle and the nerve outer membrane are broken, the nerve trunk is completely destroyed, and continuity is lost. This type of injury is the most serious type of injury and is usually present in open injuries.

Cause

(1) Causes of the disease

Median nerve injury occurs more frequently, and the injury site is mostly in the wrist or forearm, and the injured in the upper arm or ankle is smaller.

1. Pull injury: the most common. Most of it is caused by the arm being caught in the machine.

2. Crush injury: previous arm fracture or scar contracture, often accompanied by severe extensive soft tissue injury.

3. Cut injury: glass cuts that occur in daily life or at work, or accidental injuries during forearm surgery.

4. Gunshot wounds or mis-injection of drugs into the nerve trunk: Compared with the above-mentioned injuries, there are fewer cases of these two types of injuries.

5. Ischemic contracture is also often associated with median nerve injury.

(two) pathogenesis

There is currently no relevant information.

an examination

Related inspection

Electromyography blood routine

The diagnosis of this disease is mainly based on its clinical manifestations and medical history, and the auxiliary examination is less used. Mainly to carry out some regular physical inspections. For example, EMG can help to determine whether there is nerve damage and degree.

Differential diagnosis

Due to the causes and extent of the median nerve injury, the peripheral nervous system responds completely differently to the injury. Sunderland expanded the Seddon classification to emphasize the importance of the nerve bundle structure. The median nerve injury can be divided into five levels (degrees) according to this standard:

1I degree nerve injury, that is, nerve loss: axonal continuity exists but conduction is interrupted, the change of conduction block is reversible, and recovery is fast and complete.

2 II degree nerve injury, that is, axonal disruption: axon and myelin injury, but the endometrial tissue is not damaged. The Waller's degeneration occurs in the distal segment below the injury site, and the function is fully recoverable.

3III degree nerve injury, that is, nerve fiber damage in the nerve bundle: including axons, myelin sheath and endoneurium, but the nerve bundle membrane is intact. Because of the formation of scar tissue in the endometrium, some of the regenerated fibers cannot cross the distal end of the scar and cannot be completely regenerated. The degree of functional recovery is mainly related to the scar in the intima and the movement of the intraductal membrane and the distribution of sensory fibers.

4IV degree nerve injury: that is, nerve bundle injury and rupture, including axon, endometrium, and nerve bundle membrane, only the outer membrane of the nerve is intact, and the continuity of nerve trunk is maintained only by the outer membrane of the nerve. Scars in the nerve can completely block the regenerative nerve from reaching the target organ. If surgery is not taken, the motor and sensory functions cannot be restored.

5V degree nerve injury: the nerve trunk fracture, the nerve bundle and the nerve outer membrane are broken, the nerve trunk is completely destroyed, and the continuity is lost. This type of injury is the most serious type of injury and is usually present in open injuries.

The diagnosis of this disease is mainly based on its clinical manifestations and medical history, and the auxiliary examination is less used. Mainly to carry out some regular physical inspections. For example, EMG can help to determine whether there is nerve damage and degree.

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