A Judging Method Of Nerve Adhesion In Chronic Peirpheral Nerve Crushed Injury

Objective: Application value of epineurial drug injection in nerveadhesion and chronic peripheral nerve crushed injury.Method:27patients with chronic peripheral nerve compression acceptedsurgical treatment in our clinical unit from April2010to February2011, inwhich there were6cases of cubital tunnel syndrome,17cases of carpal tunnelsyndrome and4cases of tarsal tunnel syndrome. After perineural releaseprocedure, we exposured the crushed spot and injected appropriate amountmixture liquid of dexamethasone and lidocaine under the epineurium of nervefrom2cm proximal to the crushed spot. Then we can observed3different typesof the nerve expansion. Type1, the nerve inflated into continuous shuttle shapeand the inflation passed though the crushed spot easily; Type2, the crushednerve inflated into several parts without the formation of continuous shuttleshape, and the injection was difficult. Type3, the crushed nerve did not inflate.We treated the type1patients just with the external neurolysis, but to type2and3patients,we did the internal neurolysis after the perineural release. Allpatients accepted6months follow-up and systematic evaluation with thestandard criteria from the China Medical Association.Result: All27patients had improvement of numbness, pain anddiscomfort within48hours after surgery. The long-term follow-up results wereas follows: In17cases with external neurolysis: excellent in17cases.In10cases with both the external neurolysis and internal neurolysis: excellent in7cases, good in2cases, fair in1case.Conclusion:1. The epineurial drug injection is a credible judging method of nerve adhesion in chronic peripheral nerve crushed injury.2. The epineurial drug injection can be used as a treatment in mild tomoderate degree of nerve adhesion.