[The suture technic for damaged peripheral nerves]. / K tekhnike shva povrezhdennykh perifericheskikh nervov.

The outcomes of traditional epineural, microsurgical epineural and interfascicular sutures of the median and ulnar nerves in the lower third of the forearm were compared in children. Evidence is provided for the differential approach to applying an interfascicular and microsurgical epineural suture, as well as for limitations in the use of an interfascicular suture. The authors show it necessary to make investigations to clarify whether the fascicles on the ends of a diseased nerve may be more validly identified and whether the studies into connective and nerve tissue relationships in the suture line.

[Conclusions apropos the successes of the autotransplantation of human nerves]. / Nekotorye vyvody po povodu uspekhov autotransplantatsii nervov cheloveka.

Good results of autotransplantation of nerves in 5 patients under unfavourable conditions are reported. The author puts the question as to how is it that in a much lesser number of newly-formed fibres in the peripheral segment after autotransplantation with loss of fibres at two levels, the clinical results may sometimes be excellent in relation to restoration of movements and trophicity. A conclusion is drawn on the need for further morphological examinations of the intratruncal structure and regeneration of nerves as well as biochemical studies revealing the mechanism of the action of the factor of nerve growth. The application of an epineural suture under control of a magnifying lens with the use of the suitable microsurgical instruments and suture material is still the method of choice in most cases with nerve injuries.

[Surgical indications and surgical methods in post-traumatic management of the main arteries and nerves of upper extremities in late postraumatic period]. / Pokazaniia k operatsii i vybor metoda vmeshatel'stva pri sochetanykh povrezhdeniiakh magistral'nykh arterii i nervov verkhnei konechnosti v pozdnie sroki.

Reconstructive operations for nervous and vascular lesions of the upper extremities were carried out upon 37 cases within 2 to 46 months after trauma. The technic of operations and the results of the treatment are described.

[Evaluation of the results of the surgical treatment of nerve injuries]. / Ob otsenko rezul'tatov khirurgicheskogo lecheniia povrezhdenii nervov.

From the experience with 2341 operations for nerve injuries and from the evaluation of the results obtained in 750 cases some recommendations of rational estimation of the nerve suture have been set forth. Reliable conclusions may be drawn on the basis of an objective examination of the conductability of the injured nerve only. The duration of nerve regeneration ranges widely in conformity with the type and severity degree of the injury and depending on the results of the operation. Unsuccessful surgical interventions on the nerves are usually concerned with a severe type of an injury. Repeated operations on the nerves carried out to correct an earlier failure are not infrequently difficult to perform and have poorer results than the primary ones, even when the latters are delayed for several months. The greater number of errors happen when primary nerve suture is performed in a non-specialized medical establishment.

[Significance of the type of trauma for the outcome of nerve injury]. / Znachenie vida travmy dlia iskhoda povrezhdeniia nerva

The experience with 1896 restorative operations on injured nerve trunks shows a necessity to consider the problems of diagnosis, prognosis and choice of the treatment, and especially the results of the nerve suture, not in all patients with nerve injury but only in separate groups being comparable with respect to the kind and severity of the trauma. The probability of spontaneous recovery after cut and prick wounds is very small, if the signs of complete interruption of the conductivity are revealed from the very beginning. As a rule, nerve suture seems to be indicated after establishing the precise diagnosis. Rush and inadequate operations in primary surgical treatment of the wound, in particular, can cause an additional and severe trauma of the nerve, which repairing proves to be difficult and sometimes even impossible. In bone fractures the operation on injured nerves may be indicated after establishing the precise diagnosis during the period of "justified wating", taking into account the injury level and details of the clinical course. In traction lesions of the brachial plexus the correct diagnosis of the level and severity of the trauma must be established without an operation.