Plastic and Reconstructive Surgery

doi: 10.25005/2074-0581-2020-22-2-262-268
CLINICAL IMPORTANCE OF DIVIDING DISTAL COMPLETE NERVE DAMAGES OF THE UPPER EXTREMITY INTO TOPOGRAPHIC ZONES

G.M. Khodzhamuradov1, M.F. Odinaev1, N. Gafur2, M.F. Radzhabov1, Kh.I. Sattorov3, M.S. Saidov1

1Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
2Clinic of Vascular and Endovascular Surgery of Nuremberg, Nuremberg, Germany
3Department of Surgical Diseases № 2, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To show the clinical significance of dividing distal complete nerve damages of the upper extremity into topographic zones for the optimal reconstruction of the nerve at distal branching segment.

Methods: Clinical material of 109 patients represented with damages of 129 nerve branches at the distal segment. Median nerves were cut in 63 cases (48.8%), ulnar nerve – 44 cases (34.1%), radial nerve – in 22 cases (17.1%). Three types of reconstruction were applied: emergency primary end to end repair – 57 nerves, secondary end to end repair 34 nerves, and autoneuroplasty – 38 nerves. Distal injuries were classified into three zones: I zone – above the segment of nerves separation of branch ends – 39 nerve trunks (30.2%), II zone – at the level of branching – 66 nerve trunks (51.2%), and III zone – more distal cut of single or multiple terminal branches – 24 nerves (18.6%).

Results: Excellent and good results were obtained in 95.2% of cases after primary end to end nerve repair. Secondary end to end repair and nerve grafting showed 82-85% of good and excellent results.

Conclusion: Classification developed for distal nerve damage is a tool for performing a high-quality revision of the damaged area with full identification of the damage pattern and restoration of the previous anatomy

Keywords: Nerve-injured zones, distal damages of nerves, upper extremity, primary nerve repair, secondary nerve repair, autoneuroplasty.

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Authors informations:

Khodzhamuradov Gafur Мukhammadmukhsinovich
Doctor of Medical Sciences, Senior Researcher, Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: F-4112-2018
ORCID ID: 0000-0002-7095
SPIN: 1726-7169
E-mail: gafur@tojikiston.com

Odinaev Mirali Fayzulloevich
Researcher, Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: C-5172-2019
ORCID ID: 0000-0002-5361-1724
SPIN: 5388-9704
E-mail: mirali67@mail.ru

Nargis Gafur, PhD, Clinical Doctor, Clinic of Vascular and Endovascular Surgery of Nuremberg
Researcher ID: AAG-8717-2020
ORCID ID: 0000-0002-5025-5111

Radzhabov Mekhrubon Farukhovich
Researcher, Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery
ORCID ID: 0000-0002-6766-1431
SPIN: 2146-3932
E-mail: merikrf@yandex.ru

Sattorov Khabibullo Izzatulloevich
Postgraduate Student, Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2891-0570
E-mail: habibullo.sattorov0009@mail.ru

Saidov Makhmadullo Sayfulloevich
Researcher, Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: E-8505-2018
ORCID ID: 0000-0001-9003-1609
SPIN: 6838-1053
E-mail: mahmad_jon1974@mail.ru

Information about the source of support in the form of grants, equipment, and drugs

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflict of interest: No conflict

Address for correspondence:

Saidov Makhmadullo Sayfulloevich
Researcher, Department of Reconstructive Surgery, Republican Scientific Center for Cardiovascular Surgery

734003, Republic of Tajikistan, Dushanbe, Sanoi str., 33

Tel.: +992 (918) 626332

E-mail: mahmad_jon1974@mail.ru

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