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Nerve Injury Management - Part 2
Dr. Sun - Nerve Injury Management - Part 2
Dr. Sun - Nerve Injury Management - Part 2
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Pdf Summary
The document discusses the use of electrodiagnostic studies (EDS) in nerve transfer surgeries for various conditions. EDS can help evaluate potential recipient and donor muscles, monitor recovery post-operatively, and determine prognostic factors such as CMAP amplitude, motor unit recruitment, and motor unit morphology. EDS can also assess the trajectory of motor unit recruitment and identify anomalous innervation. Nerve transfer surgeries are typically performed between 3 and 6 months after injury, while tendon transfer surgeries can be considered after 6 months. Pre-surgery evaluation of nerve transfer donors includes assessing the health and redundancy of the donor nerve and muscle. EDS is used post-surgery to monitor recovery and determine if additional surgery or changes in rehabilitation therapy are necessary. In cases of spinal cord injury, EDS can assess the degree of lower motor neuron involvement and help determine the timing of nerve transfer surgeries. The document includes several case studies, such as a patient with radial neuropathy who showed improvement without surgery, a patient with ulnar neuropathy who underwent tendon transfer surgeries, a patient with tetraplegia who was not a suitable candidate for triceps nerve transfer, and a patient with peroneal nerve injury who experienced gradual improvement and was able to run a marathon.
Keywords
electrodiagnostic studies
nerve transfer surgeries
CMAP amplitude
motor unit recruitment
motor unit morphology
tendon transfer surgeries
spinal cord injury
lower motor neuron involvement
radial neuropathy
ulnar neuropathy
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