NERVE INJURIES IN THE LOWER LIMB.pdf

NERVE INJURIES IN THE LOWER LIMB *4-Neurotmesis;This means division of the N by an open wound, if complete,no nerve recovery without surgical intervention to convert it to axontmesis. *However new axons may fail to reach the distal segment or find the tube or find the target organ(neuroma)...

NERVE INJURIES IN THE LOWER LIMB *4-Neurotmesis;This means division of the N by an open wound, if complete,no nerve recovery without surgical intervention to convert it to axontmesis. *However new axons may fail to reach the distal segment or find the tube or find the target organ(neuroma) * *Healing is by disintegration (wallarian degeneration resorbed by (phagocytosis) followed by regeneration of the axon & CLINICAL FEATURES H/O FRACTURE,DISLOCATION,INJURIES NUMBNESS,WEAKNESS. ABNORMAL POSITION ( FOOT OR WRIST DROP). DIAGNOSIS 1-Tinels sign,for progressive * recovery. 2-EMG & NCS  FEMORAL NERVE *Injuries are due to:gun shot,traction in operation, hematoma. *CF weakness of knee extension depressed knee reflex ,sensation problems in thigh & leg. *RX early rx is essential; evacuate hematoma suture or graft a cut nerve.  SCIATIC NERVE This is due to; truma,dislocation ,gunshot,iatragenic accident. Tractions & compression. CF foot drop, numbness & parasthesia & pain in the leg & foot. Muscles wasting or weakness,trophical ulcers. RX reduction of dislocation,exploration in open lesion,splint. PX,poor, late, partial. Tendon transfer amputation is better than flail Joint.  PERONEAL NERVE Causes ; knee trauma varus,splints,slaps. CF foot drop, eversion loss.leg & dorsum sensory loss. -1st cleft sensation loss is due to deep PN. -anterior compartment syn.may cause deep PN palsy. Rx ;open lesion needs explor.compartment syn.needs release, splints skin care. Tendon transfer for disability THANK YOU