Zusammenfassung
Periphere Nerven können durch traumatische Schädigungen im Rahmen von Unfällen oder durch andere äußere Einflüsse ihre Funktion verlieren. Während konservative Therapieverfahren bei einer Neurapraxie bzw. Axonotmesis infrage kommen, ist bei einer kompletten bei Durchtrennung des Nervs im Sinne einer Neurotmesis die chirurgische Intervention notwendig. In diesem Kapitel wird die chirurgische Therapie mit detaillierter Beschreibung der Technik der primären Nervennaht und der Nerventransplantation dargestellt. Weiterhin wird in diesem Zusammenhang auf den optimalen Zeitpunkt der Versorgung, auf mögliche Fehlerquellen sowie auf die Prognose der Funktionswiederherstellung nach Nervenrekonstruktion eingegangen.
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Literatur
AWMF Leitlinie S3, Registernummer 005-010, Stand vom: 30.06.2013. http://www.awmf.org/leitlinien/detail/ll/005-010.html
Birch R (2010) Surgical Disorders of the Peripheral Nerves. 2. ed. Springer-UK
Birch R, Achan P (2000) Peripheral nerve repairs and their results in children. Hand Clin 16: 579–595
Brushart TM (2011) Nerve repair. Oxford University Press
Carlstedt T (2007). Central Plexus Injury, Imperial College Press
Dornseifer U, Matiasek K, Fichter MA et al. (2007) Surgical therapy of peripheral nerve lesions: current status and new perspectives. Zentralbl Neurochir 68: 101–110
Elton SG, Rizzo M (2008) Management of radial nerve injury associated with humeral shaft fractures: an evidencebased approach. J Reconstr Microsurg 24: 569–573
Eppenberger P, Chhabra A, Andreisek G (2012) Magnetic resonance neurography - imaging of peripheral nerves. Radiologie up2date 12(04): 339–355
Hart AM, Terenghi G, Wiberg M (2008) Neuronal death after peripheral nerve injuryand experimentall strategies for neuroprotection. Neurological Research 30: 999–1011
Irwin MS, Gilbert SE, Terenghi G, Smith RW, Green CJ (1997). Cold intolerance following peripheral nerve injury. Natural history and factors predicting severity of symptoms. Journal of Hand Surgery, 22B: 308–316
Kern H, Carraro U, Adami N et al. (2010). Home-based functional electrical stimulation rescues permanently denervated muscles in paraplegic patients with complete lower motor neuron lesion. Neurorehabil Neural Repair 24: 709–21
Kouyoumdjian JA (2006) Peripheral nerve injuries: a retrospective survey of 456 cases. Muscle Nerve 34: 785–788
Kretschmer T, Birch R (2011) Management of acute peripheral nerve injuries. In: Winn RH, ed. Youmans Neurological Surgery, 6th Edition, 4 Vol
Medical Research Council (MRC) (1975) Aids to the Examination of the Peripheral Nervous System. Memorandum No.45. London: Her Majesty's Stationary Office
Millesi H, Meissl G, Berger A (1972) The interfascicular nervegrafting of the median and ulnar nerves. J Bone Joint Surg Am 54(4): 727–50
Miyamoto Y (1979) Experimental study of results of nerve suture under tension vs. nerve grafting. Plast Reconstr Surg 64: 540–9
Moberg E (1958) Objective methods for determining the functional value of sensibility in the hand. J Bone Joint Surg Br 40-B: 454–476
Mödlin M, Forstner C, Hofer C et al. (2005) Electrical stimulation of denervated muscles: first results of a clinical study. Artif Organs 29(3): 203–6
Radtke C, Vogt PM (2014) Nerve injuries and posttraumatic therapy]. Unfallchirurg 117(6):539-55; quiz 556
Risitano G, Cavallaro G, Merrino T, Coppolino S, Ruggeri F (2002) Clinical results and thoughts on sensory nerve repair by autologous vein graft in emergency hand reconstruction. Chir Main 21: 194–197
Rochkind S, Drory V, Alon M, Nissan M, Ouaknine GE (2007) Laser phototherapy (780nm), a new modality in treatment of long-term incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. Photomed Laser Surg 25: 436–42
Ruijs AC, Jaquet JB, Kalmijn S, Giele H, Hovius SE (2005) Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair. Plast Reconstr Surg 116: 484–94
Sameem M, Wood TJ, Bain JR (2011) A systematic review on the use of fibrin glue for peripherall nerve repair. Plast Reconstr Surg 127: 2381–90
Shao YC, Harwood P, Grotz MR, Limb D, Giannoudis PV (2005) Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J Bone Joint Surg Br 87: 1647–52
Siemionow M, Brzezicki G (2009) Current techniques and concepts in peripheral nerve repair. Int Rev Neurobiol 87: 141–72
The Management of Nerve Injuries: A Guide from the British Orthopaedic Association. First published in 2011 by the British Orthopaedic Association. http://www.boa.ac.uk/wp-content/uploads/2014/01/The-Management-of-Nerve-Injuries.pdf
Uzun N, Tanriverdi T, Savrun FK et al. (2006) Traumatic peripheral nerve injuries: demographic and electrophysiological findings of 802 patients from a developing country. J Clin Neuromuscul Dis 7: 97–103
Waller A (1850) Experiments on the glossopharyngeal and hypoglossal nerves of the frog and observations produced thereby in the structure of their primitive fibers. Philos Trans R Soc London 140: 42–3
Weinstein S (1993) Fifty years of somatosensory research: from the Semmes-Weinstein monofilaments to the Weinstein Enhanced Sensory Test. J Hand Ther 6: 11–22
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Radtke, C., Vogt, P. (2016). Mikrochirurgische Nervenkoaptation. In: Kneser, U., Horch, R., Lehnhardt, M. (eds) Grundkurs Mikrochirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48037-3_12
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