Radial Nerve Injury

　　Ο τραυματισμός του νεύρου του ραβδίου είναι συχνός, ελέγχει την κίνηση πολλών μυών, όπως του τριπλού μυός του ώμου, του μυός του ώμου, του μακρού μυός του ραβδίου, του μυός του τραπεζοειδούς, του μυός του εκτάτη και άλλων, όταν τραυματίζεται το νεύρο του ραβδίου, μπορεί να προκαλέσει πολλά σοβαρά προβλήματα όπως η παράλυση των δακτύλων, οπότε τι είναι η αιτία του τραυματισμού του νεύρου του ραβδίου;

　　1Άρα, επειδή το νεύρο του ραβδίου βρίσκεται κοντά στο οστό του ώμου και είναι επίσης κοντά στο ράβδο του βραχίονα, συχνά τραυματίζεται ταυτόχρονα με τον βραχίονα και μπορεί να κρυφτεί στην οστεοχόνδρωση κατά τη διάρκεια της ανόρθωσης του οστού.

　　2、Τραυματισμοί από τράβηγμα ή πίεση, όπως η μακροχρόνια εξάπλωση του άνω άκρου ή το κεφάλι να κοιμάται στο άνω άκρο.

　　3、Τραυματισμοί από πυροβολισμούς ή κόψιμοι. Στη διάρκεια του πολέμου ή των αγώνων, μπορεί να προκαλέσουν άμεσο τραυματισμό.

　　4、Τραυματισμοί από χειρουργικές επεμβάσεις, όπως η αφαίρεση του κώμματος του ραβδίου ή η χειρουργική επέμβαση του οστεώματος του ώμου.

　　5、Καθώς η οστεοχόνδρωση αυξάνεται σε όγκο ή η αρθροπάθεια του ραβδίου μπορεί να πιέσει τον νεύρο του ραβδίου.

　　Since the common peroneal nerve controls many muscle groups, when there is a common peroneal nerve injury, the movement function of the related muscles controlled by it will appear disorders, which are manifested externally as movement obstruction in the upper arm, specifically as follows three points:

　　1the forearm cannot be supinated

　　2the fingers cannot be extended

　　3the thumb cannot be abducted

　　Since the common peroneal nerve controls the contraction and relaxation of many muscles, when there is a common peroneal nerve injury, it will cause movement disorders in the corresponding muscle groups, which are manifested as follows:

　　1motor

　　When the common peroneal nerve is injured in the upper arm, all the extensors are paralyzed, including the triceps brachii, brachioradialis, extensor carpi radialis longus, supinator, extensor digitorum communis, extensor carpi ulnaris, and the intrinsic extensors of the thumb and little finger. Therefore, there is wrist drop, the thumb and all fingers drop, cannot extend the metacarpophalangeal joint, the forearm has a pronation deformity, cannot supinate, and the thumb has an adduction deformity.

　　When checking the triceps brachii and extensor carpi radialis muscles, they should all be carried out in the opposite direction of the Earth's gravity. The thumb loses the function of abduction, cannot stabilize the metacarpophalangeal joint, and the function of the thumb is severely impaired. Because the extensor carpi ulnaris and the extensor carpi radialis brevis are paralyzed, it is difficult to move the wrist to both sides. The muscles on the dorsal side of the forearm are atrophic. The common peroneal nerve injury on the dorsal side of the forearm is mostly interosseous dorsal nerve injury, with no effect on sensation and triceps brachii, and the extensor carpi radialis longus is good. Other extensors are paralyzed.

　　2sensation

　　After common peroneal nerve injury, there is sensory disturbance in the lateral half of the palm, the two lateral half fingers, the upper arm and the posterior part of the forearm.

　　Common peroneal nerve injury often occurs in the middle and lower segment of the humerus fracture. Therefore, once there is a patient with displaced middle and lower segment humerus fracture, whether with common peroneal nerve injury or not, it is recommended to avoid manual reduction as much as possible to avoid causing or aggravating common peroneal nerve injury, which will bring difficulties to later treatment; at the same time, it must be checked before surgery whether the function of common peroneal nerve is normal, and then according to the degree of damage of common peroneal nerve, formulate the corresponding surgical plan, so as to minimize the damage to common peroneal nerve.

　　Common peroneal nerve injury is relatively common. Generally, when diagnosing common peroneal nerve injury, routine physical examination is mainly carried out. The most common is electromyography examination.

　　Electromyography examination is a common examination item. A single discharge of impulse from a motor neuron can cause the synchronous contraction of all the muscle fibers it支配, and the recorded potential is MUP. Normally, a nerve impulse causes all the muscle fibers of a motor unit to discharge synchronously, producing a MUP. But in the denervated muscle fibers, it is not like this, the denervated muscle fibers in2After a week, the sensitivity to acetylcholine increases, reaching normal levels100 times. They spontaneously release potential, that is, fibrillation potential. Electromyography has important diagnostic value for peripheral nerve injury. Abnormalities in electromyography can only prove neurogenic damage, while changes in electromyography make the localization of damage more obvious. MCV is very sensitive to peripheral nerve trauma, which is related to the easy injury of motor fibers. Through electromyography examination, we can determine the degree of injury.

　　1Complete injury

　　There is spontaneous activity, no MUP, and CMAP, SNAP, and MNCV all disappear.

　　2Severe injury

　　There is spontaneous activity, no MUP, decreased CMAP amplitude, decreased SNAP, or disappearance, and slowed or disappeared MNCV.

　　3Incomplete injury

　　There is spontaneous activity or prolonged insertion potential, reduced MUP, decreased CMAP, decreased SNAP, normal or slowed MNCV.

　　Diet plays a significant role in the treatment of radial nerve injury. If the diet is not appropriate, it can affect the speed of disease recovery. So, how should radial nerve injury patients eat to recover faster?

　　1Supplement nutrition by eating more vitamin-rich foods.

　　2Eat more oatmeal.

　　3Drink pure natural royal jelly. It is also beneficial to drink pure natural royal jelly daily to enhance immunity and help with disease recovery. Sweet foods can have a tonifying, harmonizing, and calming effect. Eat less cold and cool foods, more warm and nourishing foods: for example, mustard greens, mung beans, kelp, nori, seaweed, cabbage, cauliflower, watermelon, bitter melon, winter melon, etc., all belong to cold and cool foods, and patients should avoid eating them as much as possible.

　　Closed fractures of the humerus with radial nerve injury are mostly nerve contusions, less commonly rupture injuries, and are generally treated conservatively first, with surgery for exploration if ineffective. Exploration includes the exposure of the radial nerve in the axilla and upper arm, and the radial nerve in the elbow and forearm. Nerve surgery is performed according to the nature of the nerve lesion seen during surgery.

　　1According to the injury, nerve decompression, release, or suture is adopted. If necessary, methods such as flexing the elbow, internal adduction of the shoulder, and anterior shift of the nerve are used to overcome defects. If there are many defects, nerve transplantation surgery is performed. The effect after nerve anastomosis is better than that of the median nerve and the ulnar nerve.

　　2If the nerves cannot be repaired, a procedure for transferring the flexor tendons of the forearm to reconstruct the extensor function can be performed, which is effective. Paralysis of the triceps brachii is not very serious, as the relaxation of the flexor muscles and gravity can straighten the elbow joint.

　　3Use a吊带弹簧夹板before the nerves recover to reduce overstretching of the extensors and affect the efficacy.