PERIPHERAL NERVE INJURIES Mansoor khan
A N A T O M Y Connective tissue  (epineurium, perineurium, endoneurium)  Nerve tissue (axon, schwann cell)
A N A T O M Y EPINEURIUM PERINEURIUM ENDONEURIUM VESSELS
PERRIPHERAL NERVE INJUIES NERVE INJURIES Acute injury Chronic injury
N  e  u  r  o  p r a  x  i  a Mildest form, reversible conduction block (function loss), for hours or days due to direct m...
A  x  o  n  t  m  e  s  i  s
N  e  u  r  o  t  m  e  s  i  s
 
C l i n i c a l  S i g n s Motor function, Tinel’s sign (positive-sensory function negative (after 4-6weeks)-total interru...
Muscle atrophy start : post-injury 1 month peak : 3rd - 4th month
C h r o n i c  N e r v e  E n t r a p m e n t Paresthesia Loss  of function Pain
P a t h o p h y s i o l o g y Direct compression Segmental demyelination Wallerian degeneration(distal) Ischemia Swelling ...
C a r p a l  T u n n e l  S y n d r o m e
PREGNANCY TYPE WRITING
PAIN & PARASTHESIA DISTRIBUSION
RELEASE SURGERY
SUPRA-CONDYLAR FRACTURE anterior displacement   M E D I A N N E R V E
Radial Nerve  Entrapment Posterior Interosseous Nerve Syndrome
Radial Nerve  Entrapment Posterior Interosseous Nerve Syndrome
RADIAL NERVE INJURY Fracture of shaft of humrus
RADIAL NERVE INJURY WRIST DROP
GUYON’S CANNAL SYNDROME   U L N A R N E R V E
CUBITAL TUNNEL SYNDROME   U L N A R N E R V E
Benediction posture CLAWING OF RING & LITTLE FINGER U L N A R N E R V E
FROMENT’S SIGN   Flexior pollicus longus (median nerve) compensates for a weak adductor pollicis (ulnar nerve)   U L N A R...
CUBITAL TUNNEL SYNDROME   Ulnar nerve Release surgery   U L N A R N E R V E
COMMON PERONEAL Fracture of the head of fibula
PERONEAL NERVE INJURY SYMPTOMS Decreased sensation, Slapping gait, foot drop, toes drag
FACIAL NERVE  Anatomy
FACIAL NERVE  Anatomy
FACIAL NERVE PALSY  LOSS OF FRONING, DROOPING, EYEBROW DROP
C o n s e r v a t i v e  t r e a t m e n t  Indications Short history, mild-moderate, intermittent,  reversible cause (pre...
T  r  e  a  t  m  e  n  t Time of operation Open injury Closed injury Early intervention Delayed intervention Delayed inte...
S u r g i c l  I n d i c a t i o n s
E p i n e u r a l  R e p a i r
F a s c i c u l a r  R e p a i r
N e r v e  G r a f t
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Neuronal injuries

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Neuronal injuries

  1. 1. PERIPHERAL NERVE INJURIES Mansoor khan
  2. 2. A N A T O M Y Connective tissue (epineurium, perineurium, endoneurium) Nerve tissue (axon, schwann cell)
  3. 3. A N A T O M Y EPINEURIUM PERINEURIUM ENDONEURIUM VESSELS
  4. 4. PERRIPHERAL NERVE INJUIES NERVE INJURIES Acute injury Chronic injury
  5. 5. N e u r o p r a x i a Mildest form, reversible conduction block (function loss), for hours or days due to direct mechanical compression, ischemia, mild burn trauma or stretch
  6. 6. A x o n t m e s i s
  7. 7. N e u r o t m e s i s
  8. 9. C l i n i c a l S i g n s Motor function, Tinel’s sign (positive-sensory function negative (after 4-6weeks)-total interruption, Sweating-sympathetic fiber, Sensory function
  9. 10. Muscle atrophy start : post-injury 1 month peak : 3rd - 4th month
  10. 11. C h r o n i c N e r v e E n t r a p m e n t Paresthesia Loss of function Pain
  11. 12. P a t h o p h y s i o l o g y Direct compression Segmental demyelination Wallerian degeneration(distal) Ischemia Swelling of nerve Microcompartment SD
  12. 13. C a r p a l T u n n e l S y n d r o m e
  13. 14. PREGNANCY TYPE WRITING
  14. 15. PAIN & PARASTHESIA DISTRIBUSION
  15. 16. RELEASE SURGERY
  16. 17. SUPRA-CONDYLAR FRACTURE anterior displacement M E D I A N N E R V E
  17. 18. Radial Nerve Entrapment Posterior Interosseous Nerve Syndrome
  18. 19. Radial Nerve Entrapment Posterior Interosseous Nerve Syndrome
  19. 20. RADIAL NERVE INJURY Fracture of shaft of humrus
  20. 21. RADIAL NERVE INJURY WRIST DROP
  21. 22. GUYON’S CANNAL SYNDROME U L N A R N E R V E
  22. 23. CUBITAL TUNNEL SYNDROME U L N A R N E R V E
  23. 24. Benediction posture CLAWING OF RING & LITTLE FINGER U L N A R N E R V E
  24. 25. FROMENT’S SIGN Flexior pollicus longus (median nerve) compensates for a weak adductor pollicis (ulnar nerve) U L N A R N E R V E
  25. 26. CUBITAL TUNNEL SYNDROME Ulnar nerve Release surgery U L N A R N E R V E
  26. 27. COMMON PERONEAL Fracture of the head of fibula
  27. 28. PERONEAL NERVE INJURY SYMPTOMS Decreased sensation, Slapping gait, foot drop, toes drag
  28. 29. FACIAL NERVE Anatomy
  29. 30. FACIAL NERVE Anatomy
  30. 31. FACIAL NERVE PALSY LOSS OF FRONING, DROOPING, EYEBROW DROP
  31. 32. C o n s e r v a t i v e t r e a t m e n t Indications Short history, mild-moderate, intermittent, reversible cause (pregnancy, oral contraceptive, endocrine abnormalities, type writer) Method Non-steroidal anti-inflammatory drugs, splint
  32. 33. T r e a t m e n t Time of operation Open injury Closed injury Early intervention Delayed intervention Delayed intervention
  33. 34. S u r g i c l I n d i c a t i o n s
  34. 35. E p i n e u r a l R e p a i r
  35. 36. F a s c i c u l a r R e p a i r
  36. 37. N e r v e G r a f t

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