Prevalence And Surgical Treatment Study On Peripheral Nerve Injuries Of The 5.12 Wenchuan Earthquake Victims

Part 1Objective:To investigate the epidemiological characteristics of Peripheral Nerve Injury (PNI) in Wenchuan Earthquake victims. Method:Based on the injury classification, we analyzed earthquake-caused nerve injuries and performed an investigation on the injury course and nerve recovery. Result:503 patients with earthquake nerve injuries were surveyed. Soft injury significantly associated with nerve injury.73 patients who did not have any bodily injuries caused directly by external force had motor and sensory dysfunction, and LSUHSC score gets lower as trap duration gets longer. The compartment syndrome is associated with the severity. Tibial nerves were found be compressed by the tendinous arch of the soleus. In first year, LSUHSC score in 3-5 grade increased from 28.16% to 81.81%. If scores were still poor (0 or 1) after one year, further treatment was not very effective. Conclusion:Earthquake nerve injury was highly related to the crush direct and indirect from soft tissue.Part 2Objective To investigate the epidemiological characteristics of Phantom Limb Pain (PLP) in amputees due to Wenchuan Earthquake trauma, and the correlative risk factors of PLP was analyzed. Methods All amputees of Mianzhu County were screened for PLP. From August 2008 to May 2010, follow-ups via telephone were performed every 3 months until to 2 years after amputation. Results Of 147 amputees investigated,86 developed PLP in 2 years, at a prevalence rate of 79.6%. The incidence of PLP were 61.1%,62.9%,68.5%,70.4%,69.4%,66.7%,62.0% and 62.0%. More women were subjected to PLP than men (88.7% versus 67.4%). Conclusion A relatively high incidence of PLP was found in amputees suffered Wenchuan Earthquake. Women were more likely developing a PLP.Key Words: Earthquake injuries; Traumatic amputation; Phantom limb pain;Part 3Objective To investigate the clinical characteristics and surgery treatment of Advanced Peripheral Nerve Injury (APNI) in Wenchuan Earthquake victims. Methods From July 2009 to February 2011, APNI patients among 503 Wenchuan Earthquake victims with Peripheral Nerve Injury (PNI) went through surgeries to the nerves or to reconstruction. Postoperative symptoms and limb function was observed. Results Of the 503 patients,72 (14.3%) PNIs had developed into APNIs, and of which 60 patients underwent surgery while 12 cases met exclusion criteria. In total we performed 4 auto nerve grafts,3 acellular nerve allografts,21 functional reconstruction and 42 neurolysis. Conclusion As APNI is concerned, a surgery with positive attitude is a feasible and effective method of treatment. Key Words:Advanced Peripheral Nerve Injury; Surgery; TherapyPart 4Objective To investigate the clinical efficacy of a painful stump neuroma treatment by resection and nerve stump implantation into a muscle in treating Wenchuan Earthquake amputees. Methods In 12 Wenchuan Earthquake amputees (12 patients,27 painful neuromas), painful neuroma underwent resection and implantation into a nearby muscle. Change of symptoms and limb function was observed. Results All cases were followed up for 12-26 months, an average of 16 months. It was shown that limb stump pain and "electric-shock" sensation disappeared, no local tenderness, percussion tenderness and Tinel sign, soft tissue nodule or mass of limb stump disappeared. Conclusion Resection and nerve stump implantation into a muscle is a feasible and effective method of treatment to painful stump neuroma after amputation.