Peripheral nerve injury refers to the injury that occurs when the working branches of peripheral nerves are acted upon by external forces, either directly or indirectly. Common injuries include crush injury, strain injury, cut injury, injection injury and surgical misuse injury. Peripheral nerves are mostly mixed nerves, including motor nerves, sensory nerves and autonomic nerves. The typical performance after injury is motor disorders, sensory disorders and autonomic dysfunction.
1.Injury classification.
Nerve disuse, axon disruption, nerve rupture, etc.
2, clinical manifestations.
Peripheral nerve injury is often accompanied by a variety of tissue injuries, such as fractures, vascular injuries, muscle tears, soft tissue swelling, visceral organ injuries, traumatic brain injury and infection. Limb dysfunction after injury is mainly manifested as muscle atrophy, paralysis, sensory numbness or loss, joint contracture or deformity, etc. (Motor disorders, sensory disorders, reflex disorders, etc.)
3, rehabilitation assessment.
The purpose of rehabilitation assessment is to understand the degree of peripheral nerve injury, judge the prognosis, determine the rehabilitation goal, formulate rehabilitation plan, and evaluate the rehabilitation effect, etc.
Motor function assessment.
(1) look for skin integrity, muscle swelling or atrophy, limb deformity, gait and posture abnormalities.
(2) Measurement of limb circumference.
(3)Assessment of muscle strength and joint range of motion.
(4) Assessment of motor function recovery, etc.
Sensory function assessment.
(1)Sensory function assessment including touch, pain, temperature, pressure, two-point discrimination, skin localization, skin figure discrimination, solidity, kinesthesia, position, etc.
(2) Assessment of sensory function recovery.
Electrophysiological assessment: It is important to determine the location, scope, nature, degree and prognosis of peripheral nerve injury.
4, rehabilitation treatment.
The purpose of rehabilitation treatment to prevent comorbidity, prevent and release muscle and tendon contractures, joint stiffness, prevent muscle atrophy, enhance muscle strength, restore motor and sensory function, and ultimately restore the patient’s ability to live and work.
Prevention of comorbidities.
(1) edema elevation of the affected limb, compression by elastic bandage, experiential contraction of the immobilized limb, gentle centripetal massage of the affected limb, passive exercise and physiotherapy, such as hot compresses, warm baths, waxing therapy, infrared, ultrashort wave, short wave, microwave, etc.
(2) Contracture: passive stretching of contracted muscles and tendons requires slow, gentle movements with gradually increasing range, massage of the affected limb, physiotherapy such as warm heat therapy, ultrasound therapy, direct current iodine example introduction, hydrotherapy and water exercise, etc.
(3) Secondary trauma.
Prevent myasthenia gravis, enhance muscle strength and promote the recovery of motor function. Myasthenia gravis develops rapidly from early on after injury and needs to be prevented early. Commonly used methods: electrical stimulation, electroacupuncture, massage, passive exercise, myoelectric feedback training, power-assisted exercise, active exercise and resistance exercise, etc.