PDF(Pubmed)
Abstract：
BACKGROUND: Understanding patterns of peripheral nerve injuries (PNIs) and brachial plexus injuries (BPIs) is essential to preventing and appropriately managing nerve injuries. We sought to assess the incidence, cause, and severity of PNIs and BPIs sustained by patients with trauma.
METHODS: We conducted a retrospective review of the Trauma Registry Database (January 2002 to December 2020) to identify patients with PNIs or BPIs.
RESULTS: We evaluated data from 24 905 patients with trauma; 335 (1.3%) sustained PNIs (81% male; mean age 36 yr, standard deviation [SD] 16 yr) and 64 (0.3%) sustained BPIs (84% male; mean age 35, SD 15 yr). Nerves in the upper extremities were more commonly affected than those in the lower extremities. Sharp injuries (39.4%) and motorcycle accidents (32.8%) were the most frequent causes of PNIs and BPIs, respectively. Other common causes of PNI were motor vehicle collisions (16.7%) and gunshot wounds (12.8%). Many patients with PNIs (69.0%) and BPIs (53%) underwent operative management. The most frequent reconstruction for PNI was primary nerve repair (66%), while nerve transfers (48%) were more frequently used for BPI.
CONCLUSIONS: Nerve injuries in the trauma population have decreased over the last 3 decades with shifts in mechanisms of injury and use of imaging, electrodiagnostic tests, and surgery. Nerve injuries are often complex and time-sensitive to treat; understanding changes in trends is important to ensure optimal patient management.
METHODS: We conducted a retrospective review of the Trauma Registry Database (January 2002 to December 2020) to identify patients with PNIs or BPIs.
RESULTS: We evaluated data from 24 905 patients with trauma; 335 (1.3%) sustained PNIs (81% male; mean age 36 yr, standard deviation [SD] 16 yr) and 64 (0.3%) sustained BPIs (84% male; mean age 35, SD 15 yr). Nerves in the upper extremities were more commonly affected than those in the lower extremities. Sharp injuries (39.4%) and motorcycle accidents (32.8%) were the most frequent causes of PNIs and BPIs, respectively. Other common causes of PNI were motor vehicle collisions (16.7%) and gunshot wounds (12.8%). Many patients with PNIs (69.0%) and BPIs (53%) underwent operative management. The most frequent reconstruction for PNI was primary nerve repair (66%), while nerve transfers (48%) were more frequently used for BPI.
CONCLUSIONS: Nerve injuries in the trauma population have decreased over the last 3 decades with shifts in mechanisms of injury and use of imaging, electrodiagnostic tests, and surgery. Nerve injuries are often complex and time-sensitive to treat; understanding changes in trends is important to ensure optimal patient management.
摘要：
背景：了解周围神经损伤（PNI）和臂丛神经损伤（BPI）的模式对于预防和适当管理神经损伤至关重要。我们试图评估发病率，cause,创伤患者持续的PNI和BPI的严重程度。
方法：我们对创伤登记数据库（2002年1月至2020年12月）进行了回顾性审查，以确定患有PNI或BPI的患者。
结果：我们评估了24905例创伤患者的数据；335（1.3％）持续PNI（81％男性；平均年龄36岁，标准偏差[SD]16年）和64（0.3％）持续BPI（84％男性；平均年龄35岁，SD15年）。上肢的神经比下肢的神经更常见。锐伤(39.4%)和摩托车事故(32.8%)是PNI和BPI最常见的原因,分别。PNI的其他常见原因是机动车碰撞（16.7％）和枪伤（12.8％）。许多PNI（69.0％）和BPI（53％）的患者接受了手术治疗。PNI最常见的重建是原发性神经修复（66％），而神经转移(48%)更常用于BPI。
结论：创伤人群中的神经损伤在过去30年中随着损伤机制和成像使用的变化而减少，电诊断测试,和手术。神经损伤通常是复杂且对治疗时间敏感的；了解趋势的变化对于确保最佳的患者管理很重要。
方法：我们对创伤登记数据库（2002年1月至2020年12月）进行了回顾性审查，以确定患有PNI或BPI的患者。
结果：我们评估了24905例创伤患者的数据；335（1.3％）持续PNI（81％男性；平均年龄36岁，标准偏差[SD]16年）和64（0.3％）持续BPI（84％男性；平均年龄35岁，SD15年）。上肢的神经比下肢的神经更常见。锐伤(39.4%)和摩托车事故(32.8%)是PNI和BPI最常见的原因,分别。PNI的其他常见原因是机动车碰撞（16.7％）和枪伤（12.8％）。许多PNI（69.0％）和BPI（53％）的患者接受了手术治疗。PNI最常见的重建是原发性神经修复（66％），而神经转移(48%)更常用于BPI。
结论：创伤人群中的神经损伤在过去30年中随着损伤机制和成像使用的变化而减少，电诊断测试,和手术。神经损伤通常是复杂且对治疗时间敏感的；了解趋势的变化对于确保最佳的患者管理很重要。
