Đặc điểm lâm sàng và chẩn đoán điện tổn thương dây thần kinh đoạn cẳng tay ở đối tượng giám định thương tích

Abstract

The purpose of this study is to describe the clinical symptoms and the degree of damage to the radial, median, and ulnar nerves from forearm injury including the assessment of abnormal nerve electrodiagnostic. The study was conducted in 30 patients with one or more nerves damage in the forearm area (ulnar, median, radial). All patients received surgical treatment including microsurgery, non - microsurgery and no nerve stitching. Patient condition was reviewed, clinical neurological examination was performed, nerve injury was assessed by the Quick DASH scale and diagnosed by measuring the nerve conduction rate and recording the needle electrodes. The results show that the left hand is more damaged than the right hand (60%); lesions are mainly found in the upper third of the forearm (46.7%). The clinical symptoms of the motor - sensory accounted for the highest percentage (74%). The lowest Quick DASH score is 16, the highest is 48 and the average is 31.4, of which the mild, moderate and severe, sequentially, are 20%, 40% and 40%. Electrodiagnostics features confirmed the latency, conduction velocity or amplitude ware markedly decreased in patients with damage to the radial, median, and ulnar nerves at forearm. Denervation accounts for a low percentage that in the group of no nerve stitching. There were no difference in conduction velocites, amplitudes and latencies between the injured hand and the normal hand on 3 groups (microsurgery, non - microsurgery and no nerve stitching). In conclusion, the left hand is more damaged than the right hand. The main damaged nerves are radial and ulnar nerves. The degree of functional damage to the forearm is moderate and severe (the Quick DASH scale). Nerves in the affected forearm are damaged by the axon - myelin and there was no difference between the 3 groups. There was low percentage of denervation in group of no nerve stitching.