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2013 ; 13
(52
): 82-92
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Ultrasound assessment of selected peripheral nerve pathologies Part III:
Injuries and postoperative evaluation
#MMPMID26672434
Kowalska B
; Sudo?-Szopi?ska I
J Ultrason
2013[Mar]; 13
(52
): 82-92
PMID26672434
show ga
The previous articles of the series devoted to ultrasound diagnostics of
peripheral nerves concerned the most common nerve pathologies, i.e. entrapment
neuropathies. The aim of the last part of the series is to present ultrasound
possibilities in the postoperative control of the peripheral nerves as well as in
the diagnostics of the second most common neuropathies of peripheral nerves, i.e.
posttraumatic lesions. Early diagnostics of posttraumatic changes is of
fundamental importance for the course of treatment and its long-term effects. It
aids surgeons in making treatment decisions (whether surgical or conservative).
When surgical treatment is necessary, the surgeon, based on US findings, is able
to plan a given type of operative method. In certain cases, may even abandon the
corrective or reconstructive surgery of the nerve trunk (when there are extensive
defects of the nerve trunks) and instead, proceed with muscle transfers. Medical
literature proposes a range of divisions of the kinds of peripheral nerve
injuries depending on, among others, the mechanism or degree of damage. However,
the most important issue in the surgeon-diagnostician communication is a detailed
description of stumps of the nerve trunks, their distance and location. In the
postoperative period, ultrasound is used for monitoring the operative or
conservative treatment effects including the determination of the causes of a
persistent or recurrent neuropathy. It facilitates decision-making concerning a
repeated surgical procedure or assuming a wait-and-see attitude. It is a
difficult task for a diagnostician and it requires experience, close cooperation
with a clinician and knowledge concerning surgical techniques. Apart from a
static assessment, a dynamic assessment of possible adhesions constitutes a
crucial element of postoperative examination. This feature distinguishes
ultrasound scanning from other methods used in the diagnostics of peripheral
neuropathies.
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