REINNERVATION OF REPLANTED EXTREMITY

Aim. To increase the efficiency of treatment of patients with traumatic amputation of the extremity using epiperineural peripheral nerve suture during replantation. Materials and methods. The results of complex surgical treatment of 64 patients with traumatic amputations of extremity segments are presented in the paper. In patients of the main group (34 patients), extremity replantation included, along with traditional stages, epiperineural suture of the nerve. The results were assessed 6 months later by clinical data taking into account topography of innervated tissues, extremity function, vascular ultrasound, roentgenography, measured electropotential of superficial tissues (Gerasimov A.A. 1986), stimulation electromyography. Results. Clinical analysis of the main group data demonstrated decrease in unsatisfactory results of reinnervation from 43,3% to 23,52% ( р <0,05), partial restoration of motor disorders from 80% to 97,06% ( р >0,05), and vegetotrophic function accompanied by development of trophic ulcers from 76,7% to 97,06% ( р >0,05) that in general improved the results of extremities replantation by 19,78% ( p <0,05). Conclusion. Application of epiperineural suture during replantation permits to reduce the number of unsatistactory results of peripheral nerve restoration by 19,78% ( p <0,05), to restore partially the motor function by 17,06% ( p <0,05), to lower the risk of developing neurotrophic ulcers of the replanted extremity by 20,36% ( p <0,05).

Microsurgery, extremity replantation, nerve suture, adults, human being