gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Ultrasonography is an essential tool in pre-operative evaluation of peripheral nerve trauma

Sonographie ist ein wichtiges Instrument in der Diagnostik von peripheren Nervenverletzungen

Meeting Abstract

Suche in Medline nach

  • corresponding author Henrich Kele - Department of Neurosurgery, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen
  • R. Verheggen - Department of Neurosurgery, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.11.09

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0115.shtml

Veröffentlicht: 23. April 2004

© 2004 Kele et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The diagnosis of peripheral nerve trauma traditionally relies on the results of clinical and electrophysiological examinations. These methods, however, do not reveal the exact location, character and cause of the lesion, for example scar formation. High-resolution sonography might help in the diagnosis of peripheral nerve trauma by means of direct visualisation of the nerve and surrounding tissues.

Methods

In the last 3 years we treated 29 patients with peripheral nerve injury diagnosed by clinical and electrophysiological methods. The ulnar nerve was affected in 14 cases, median nerve in 5, radial nerve in 6, and the sural and superficial peroneal nerves in two cases each. In 20 patients the injuries were caused by primary trauma, in 9 cases the lesion was observed after surgery. Pre-operatively, a sonographical examination was performed and correlated with neurological examinations and surgical findings.

Results

Sonographically, a total nerve transection was detected in 5 and a partial transection in 12 patients. In 4 patients compression by bone fragments, foreign bodies, haematomas or pseudoaneurysmas, and in another 3 patients a scar compression were detected. Axonal swelling alone was found in 5 patients. In each of the 24 patients undergoing surgery (transections, neuromas, compressions) the sonographical findings were in accordance with the intraoperative site. In transections, based on the condition and distance of the nerve stumps either, end-to-end neurorrhaphy, or nerve grafting were performed. External neurolysis was sufficient in all cases of nerve compression. Patients with preserved nerve continuity without displayed nerve compression were treated conservatively.

Conclusions

The morphological information provided by ultrasonography shows pre-operatively the exact location, character and extent of the nerve lesion, as well as, the affection of surrounding tissue. Ultrasonography facilitates setting up the correct therapeutic and surgical strategy, and is indispensible in preventing iatrogenic injury.