Causes and treatment in radial nerve injury / 中国矫形外科杂志

[Objective]To probe into the causes and treatments in the radial nerve injury.[Method]Twenty-nine patients with radial nerve injury were treated.Conservative measures were anti-inflammatory,repercussion,nervous pharmacotherapy,acupuncture and physiotherapy.Surgical interventions included open reduction and internal fixation,tenorrhapy,neurorrhaphy and decompression of nerve.[Result]The outcome of treatment was evaluated with the result of 19 excellent,8 good and 2 fair,in which nerve healing period was at an average of 4 months.[Conclusion]The overall effect was satisfactory in this series,among which,electro-neurogram were inconsistent with their symptoms and signs.It is important to asses the quality and degree in injury to the nerve for guiding the treatment.During internal fixation of the fractures of humerus,the exclusion and protection of the radial nerve should be carefully done.when removig the fixation the radial nerve would be protected by first dissecting normal radial nerve in distal and proximal segments,then,exposing gradually adherent segment within the scar tissue.In brief,the opportunity of injury to the radial nerve may be reduced by careful operation.

Diagnosis and treatment of post-traumatic biliary leakage / 中华创伤杂志(英文版)

OBJECTIVE: To improve the quality of management in biliary leakage following liver or bile tract injury. METHODS: All patients with liver and/or bile duct injuries from October 1987 to February 1998 inclusive were studied retrospectively in respects of their age, sex, type and mechanism of injury, the grade of liver trauma, treatment and subsequent complications. RESULTS: In 271 patients with hepatobiliary injuries, 14 (5.17%) developed a bile leak, which fell into 2 main types: Type I, injuries involving extrahepatic or first-order bile ducts (6 patients);Type II, injuries of more peripheral biliary radicles (8 patients). Most bile leakages in this series closed spontaneously in 7-14 days postoperatively. Intra-abdominal infection (28.57%) was a frequent complication which required active intervention. CONCLUSIONS: In the management of biliary leakage, it is important that (1) the leakage should be well localized; (2) adequate abdominal drainage plays a key role in controlling any type of biliary leakage; (3) decompression of the biliary tract favors the healing of injured biliary tree, especially in Type I leakage.