-=MAPLE GALAXY=-

nmvesgfqj

Limbs, 12 cases of missed diagnosis of nerve injury

Break; the middle of pregnancy fracture of God / diagnostic points of Chinese books dung circle No.: R651.3 text of a plot code: B Article Chi No. 1002-3429 (2001) 02.0101.0】 1983 to 1998 were treated in our hospital sharps 6O limb nerve injury caused by the important cases, of which 12 cases had at different times of the missed diagnosis, missed diagnosis rate of the 2O now because of the following missed. 1 1.1 The clinical data of 12 cases,[link widoczny dla zalogowanych], male 1O, female 2; age 8 to 45 years old, average 27.8 years old. 1.2 Injury Injury: 5 cases of nail stabbed, a knife stabbed four down, stabbed in 2 sides of glass,[link widoczny dla zalogowanych], wood I stab stab cases. Wound length: 03 ~ I. 0cm, an average of 0.65cm. Nerve injury: 8 cases of complete rupture, most fracture 4 Chi I. 2 cases of missed diagnosis missed 1.3 hours to 23 days, an average of 8 days. Nerve damage: deep branch of radial nerve in 4 cases, 3 cases in which the proximal forearm, elbow I patients; ulnar nerve in 3 cases, 1 case in which the wrist, palm, 1 case of supracondylar humerus 2.5cm at 1 case; wrist median nerve in 2 cases; the ankle tibial nerve in 2 cases; peroneal nerve upper leg I Chi I. 1.4 Treatment of 12 cases were repaired under the operating microscope probe, 8 cases of suture line on the side, free nerve graft in 3 cases, deep branch of radial nerve injury in line of the forearm extensor tendon transposition reconstruction of extensor pollicis function I fall. 2 discussions sharp injuries of peripheral nerve timely diagnosis, a repair is to improve the therapeutic effect of the important conditions [I_ Once missed,[link widoczny dla zalogowanych], it will affect functional recovery, increased patient pain and summarized by the salary burden of a missed diagnosis in this group 2.1 neglect small wounds following injury, which is the main reason for misdiagnosis of skin wounds in this group does not exceed the maximum Icm, the smallest is only 0.3cm,[link widoczny dla zalogowanych], in some cases associated with other parts of the larger wounds, could easily lead to There were 4 cases in this group after injury is not only simple lines for empty dressing exploration, 1 patient without any treatment, resulting in missed diagnosis, 2.2 punctures lack of knowledge, not a serious wound track clearance plane probe, the skin wound alone no significant nerve just below the corresponding inspection by the neglect of this group of ulnar nerve and median nerve injury in 2 cases of nerve injury site and the different parts of the skin damage that skin wounds in the wrist and forearm, not damage nerves; 1 case is made of Nail the back stabbing people in the wrist median nerve injury caused by negligence on the probe wound tract, a profound lesson. 2.3 tendon injury within the wound, mistakenly believe that the tendon can restore the function of hand, foot, combined with external fixation after the neurological symptoms and further concealed. This is often missed a long time, except for some up to fixed was discovered. 2.4 distal nerve injury site in the body, hand, foot dysfunction is often atypical or incomplete, in addition to other reasons for pain and do not deserve examination Erzhi missed 2.5 units of non-specialist primary hospitals to meet only the wound to stop bleeding and sew Taiwan do not attach importance to further examination, but missed a nerve injury. In short, the clinical work should pay attention to the limbs of small wound puncture wound treatment, wound debridement Road, exploration should be thoroughly detailed, carefully comprehensive examination, for the recovery of neurological function to create the best conditions for tissue repair and the timing of surgery,[link widoczny dla zalogowanych], to avoid mistakenly missed. References 1 Zhang Shaocheng paper spine. Surgical treatment of peripheral nerve injury principles see: Fan Qishen. Wang Chengqi editor. Studies of modern orthopedic microsurgery. Beijing: People's Medical Publishing Du. Xie Zhong Xi 1995.396 ~ 3972. Meng Wang, Cui Zhimin, et al. Emergency upper extremity microsurgical nerve injury repair. Chinese Journal of Microsurgery. 199,720 (1): 17 (2000 Received time. 12.10) (Continued from page 100) appears, the body temperature of about 38C, generally no more than 39C in this group who have a fever elevated body temperature NICH more than 1 to 2 days to high heat common. Temperature did not rise were more common in preterm children, and (or) a large number of intracranial hemorrhage, premature children consider themselves and (or) a large number of intracranial hemorrhage in the central nervous system dysfunction, affecting the decomposition of brown fat metabolism, body heat production at this time To reduce the temperature does not rise. So there for perinatal asphyxia or birth trauma, accompanied by changes in body temperature of newborns (especially those unexplained fever) should be alert to the occurrence of NICH, the early line of head CT, in order to understand whether the intracranial hemorrhage.