Clinical and Diagnostic Parallels Between Isolated and Combined Vascular and Nerve Injuries of the Limbs
Erroneous and untimely diagnosis of lesions of great vessels, especially combined, has severe consequences and reduces the chances of limb salvage and restoration of its function, as well as saving the patient's life.
The objective of the work — to draw parallels between isolated and combined injuries of neurovascular structures in order to optimize the timely diagnosis and to carry out proper restorative surgical treatment. The study is based on the analysis of the survey results of 103 patients with lesions of the neurovascular structures of the limbs. To determine the diagnostic features of combined limb injuries in the acute period of trauma, we have carried out a comparison of two groups: I (n = 51) — with isolated vascular injuries; II (n = 52) — with combined vascular and nerve injuries. In severe shock there should be suspicion in terms of combined limb injuries. Patients, who had combined injuries, according to clinical signs before surgery, were diagnosed with nerve injuries only in 30.8 % of cases, during surgery — in 48.1 % of cases. Damage of great vessels in typical areas must be considered a priori as combined with damage of nerve trunks before the moment when nerve injury is not excluded. Proper timely diagnosis enables to select the optimal reconstructive surgery within timeframes, beneficial for the restoration of limb function.
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