ABSTRACT
The authors treated a local complication after axillary block, probably after intraneural injection of lidocaine. At the operation severe epineural fibrosis was found and released. The result was good after some months. After this the authors realized a study with 14 hand surgeons, and only few cases like the first case were found. This technique axillary block, is very reliable technique, but very few local complications can occur, and it's necessary to know them. It's possible to avoid this local problem with a serious technique to realize axillary block. Never intraneural injection and never many punctures to research paresthesia from the nerves of the brachial plexus.
Subject(s)
Brachial Plexus , Median Nerve , Nerve Block/adverse effects , Paralysis/etiology , Adult , Axilla , France/epidemiology , Humans , Male , Nerve Block/instrumentation , Nerve Block/methods , Paralysis/epidemiology , Paralysis/surgeryABSTRACT
Defined by severe injuries of several digital structures and by lesions of several axes, complex hand injuries raise numerous problems of management. The activity of the unit "S.O.S. Hand-Reimplantation" of the Boucicaut Hospital petmitted us to determine the various clinical and socio-professional aspects. In the first part of this article, a statistical study permitted us to define the classes, types and prognosis. In the second part, the repair of each digital structure is considered (skin, bone, joint, extensors, flexors, nerves, vessels) in the light of a complex hand injury. The role of the covering skin in the quality of the results seems very important. The long-term results, their socio-professional consequences, thus permit one to draw up a therapeutic management which aims to repair the maximum number of lesions during the first stage of the operation. The interest of microsurgical repairs of the vessels and nerves requires operation of these complex hand injuries as an emergency, which requires appropriate surgical facilities.
