ABSTRACT
AIM: To study the influence of sympathectomy on nerve regeneration in human extremities. MATERIAL AND METHODS: Autoneuroplasty was performed in 86 patients with posttraumatic defects of median and ulnar nerves: in 42 cases in combination with sympathectomy (thoracoscopic clipping of Th3-4 sympathetic ganglions) and in 44 cases without sympathectomy. Computer thermography, laser Doppler flowmetry with spectral wavelet-analysis of blood flow oscillations, ultrasonography of nerve trunks and stimulation electroneuromyography were used. RESULTS AND CONCLUSION: Induced sympathectomy was for the first time shown to have a positive activating influence on the restoration of innervation and tissue trophics in the course of posttraumatic nerve regeneration. The combination of autoneuroplasty with induced sympathectomy contributes to a more complete restoration of motor and sensory nerve fibers, helps to normalize the blood flow in the microvascular bed and thermal topography of the damaged segment of the extremity and support the trophotropic direction of tissue control including the previously denervated area.
Subject(s)
Median Nerve/injuries , Median Nerve/surgery , Nerve Regeneration , Sympathectomy/methods , Ulnar Nerve/injuries , Ulnar Nerve/surgery , Adolescent , Adult , Aged , Arm/blood supply , Arm/innervation , Arm/physiology , Female , Humans , Laser-Doppler Flowmetry , Male , Median Nerve/physiology , Middle Aged , Motor Activity , Nerve Fibers/physiology , Ulnar Nerve/physiology , Wavelet Analysis , Young AdultABSTRACT
86 patients with posttraumatic defects of median and ulnar nerves were examined. Autoneuroplasty was performed at all of patients: in 42 cases--in combination with sympathectomy (thoracoscopic clipping of Th3-4 sympathetic ganglions), in 44 cases--without sympathectomy. Ultrasonography of nerve trunks, stimulation electroneuromyography, computer thermography, laser Doppler flowmetry with spectral wavelet-analysis of blood flow oscillations were used during checkup. For the first time was shown that induced sympathectomy has positive activating influence on restoring innervation and tissue trophics in the course of posttraumatic nerve regeneration. Combination of autoneuroplasty with induced sympathectomy contributes to a more complete restoration of motor and sensory nerve fibres, helps to normalize blood flow in microvascular bed and thermotopography of the damaged segment of the extremity including the previously denervated area.