War Injuries to the Extremities

Maričević, Antun; Erceg, Marinko

doi:10.1093/milmed/162.12.808

Cited by 26 publications

(13 citation statements)

References 2 publications

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“…A cascade of events involving cell signaling molecules and neurotrophic factors occurs after nerve injury (Liuzzi and Tedeschi, 1991;Zheng and Kuffler, 2000;Zochodne and Levy, 2005). The blood-nerve barrier plays an important role (Maricevic and Erceg, 1997). Schwann cells play an indispensable role in promoting regeneration by increasing their synthesis of surface cell adhesion molecules, and by elaborating basement membrane containing extracellular matrix proteins, such as laminin and fibronectin (Fu and Gordon, 1997).…”

Section: Nerve Regenerationmentioning

confidence: 99%

“…Many of the advances in knowledge about peripheral nerve injuries have occurred during wartime, from physicians on both sides of the front. In a military setting, most peripheral nerve injuries are due to shrapnel (Maricevic and Erceg, 1997). A common cause of TPNI in combat is blast injury, often from bombs or improvised explosive devices.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation and management of peripheral nerve injury

Campbell

2008

Clinical Neurophysiology

605

462

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Common etiologies of acute traumatic peripheral nerve injury (TPNI) include penetrating injury, crush, stretch, and ischemia. Management of TPNI requires familiarity with the relevant anatomy, pathology, pathophysiology, and the surgical principles, approaches and concerns. Surgical repair of TPNI is done at varying time intervals after the injury, and there are a number of considerations in deciding whether and when to operate. In neurapraxia, the compound muscle and nerve action potentials on stimulating distal to the lesion are maintained indefinitely; stimulation above the lesion reveals partial or complete conduction block. The picture in axonotmesis and neurotmesis depends on the time since injury. The optimal timing for an electrodiagnostic study depends upon the clinical question being asked. Although conventional teaching usually holds that an electrodiagnostic study should not be done until about 3 weeks after the injury, in fact a great deal of important information can be obtained by studies done in the first week. Proximal nerve injuries are problematic because the long distance makes it difficult to reinnervate distal muscles before irreversible changes occur. Decision making regarding exploration must occur more quickly, and exploration using intraoperative nerve action potential recording to guide the choice of surgical procedure is often useful.

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Section: Nerve Regenerationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation and management of peripheral nerve injury

Campbell

2008

Clinical Neurophysiology

605

462

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“…Some authors have advocated external fixation as the preferred treatment option in the management of ballistic fractures (20,21). They conducted the surgery in standard civilian hospitals and have included Gustilo-Anderson grade I and II fractures as those requiring external fixation.…”

Section: Discussionmentioning

confidence: 99%

Ballistic Fractures During The 2003 Gulf Conflict – Early Prognosis And High Complication Rate

2006

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“…Many of the advances in knowledge about peripheral nerve injuries have occurred during wartime, including World War I and II, from physicians on both sides of the front [ 10 ] . These nerve injuries were addressed under much less than ideal conditions in the fi eld, but much information was learned from their management.…”

Section: Historical Perspectivesmentioning

confidence: 99%