Extraneurolysis

Extraneural lysis is used for the treatment of peripheral nerve injury. Peripheral nerve injuries are common in both normal and wartime situations. According to some of the war damage statistics of the Second World War, nerve damage in the extremities accounted for 10% of the total number of traumas. In firearm fractures, about 60% have nerve damage. Omer reported 22% of patients with upper limb injuries with peripheral nerve injury on the battlefield in Vietnam. Usually peripheral nerve injury accounts for about 1.5% to 4% of all trauma. Proper grasp of surgical indications and timing of surgery is the key to performing surgical treatment and achieving good results. The timing of repair after nerve injury is very important. In principle, the sooner the better, but time is not an absolute factor, and late repair can also achieve certain effects. Extra-neurolysis refers to lysis outside the epicardium. Treatment of diseases: nerve compression syndrome Indication Extraneural lysis is applicable to: 1. Nerve crush injury or contusion, forming nerve and internal scar adhesion adhesion. 2. Scars around the nerves or infections after infection. 3. Old fractures or dislocations or osteophytes. 4. Neuroischemic injury. 5. Burning neuralgia. 6. Nerve traction. 7. Nerve firearms concussion injury. 8. Scar adhesion and compression after radioactive injury. Surgical procedure Incision Centering on the nerve injury site, the skin is opened by the nerve-exposed incision. The incision should be of sufficient length to expose the nerve. 2. Reveal the nerve When the nerve is exposed, it should start from the normal tissue at both ends of the injury site and gradually dissipate to the damaged site. After the nerve is released from the normal part of the incision, the nerve trunk is gently pulled up with a rubber strip, and then gradually released to the damaged part, taking care to retain the normal nerve branch. 3. Extraneural release Free to the damaged area, often a large number of scar tissue adhesion compression, with a sharp knife or small scissors to carefully separate the nerve from the scar. When the scar is dense and difficult to separate, the isotonic saline can be injected between the scar and the nerve membrane, and separated while injecting. The scar tissue around the nerve or the broken bones and osteophytes should be completely removed. Place the loosened nerves in a healthy tissue bed. 4. Suture incision After the nerve is released, relax the tourniquet, completely stop the bleeding, rinse the wound with isotonic saline, and suture layer by layer. The limb does not need to be externally fixed.