Predictors of Surgical Outcomes of Traumatic Peripheral Nerve Injuries in Children: An Institutional Experience
Aim: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). Materials and Methods: This is a retrospective study of epidemiology, operativ...
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Veröffentlicht in: | Pediatric neurosurgery 2018-01, Vol.53 (2), p.94-99 |
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creator | Devi, Bhagavatula Indira Konar, Subhas K. Bhat, Dhananjaya I. Shukla, Dhaval P. Bharath, R. Gopalakrishnan, M.S. |
description | Aim: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). Materials and Methods: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. Results: Intramuscular injections were the most common cause (52.9%), followed by entrapment (15.6%). The most common nerve involved was the sciatic nerve (54.9%), followed by the common peroneal nerve (13.7%), the ulnar nerve (10.8%), and the radial nerve (10.8%). Perineural adhesion was the most common intraoperative finding (74.5%), followed by a neuroma in continuity (14.7%) and gap (10.8%). Most of the children with peripheral adhesion underwent external and internal neurolysis (75.5%). Follow-up was available for 67 children. The median follow-up period was 7 months (range 3-36). The outcome was assessed according to MRC grading. Favorable functional improvement was noted in 76.1% of the children. Age less than 10 years (p = 0. 06), injury before 6 months (p = 0.03), and MRC motor grade ( |
doi_str_mv | 10.1159/000484174 |
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Materials and Methods: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. Results: Intramuscular injections were the most common cause (52.9%), followed by entrapment (15.6%). The most common nerve involved was the sciatic nerve (54.9%), followed by the common peroneal nerve (13.7%), the ulnar nerve (10.8%), and the radial nerve (10.8%). Perineural adhesion was the most common intraoperative finding (74.5%), followed by a neuroma in continuity (14.7%) and gap (10.8%). Most of the children with peripheral adhesion underwent external and internal neurolysis (75.5%). Follow-up was available for 67 children. The median follow-up period was 7 months (range 3-36). The outcome was assessed according to MRC grading. Favorable functional improvement was noted in 76.1% of the children. Age less than 10 years (p = 0. 06), injury before 6 months (p = 0.03), and MRC motor grade (<3) (p = 0. 01) were positive predictive factors related to the final outcome. Conclusion: Early surgical intervention, age less than 10 years, and incomplete motor palsy were the best predictors of a superior functional outcome. This study can serve as a guide to determine the epidemiology, duration of intervention, and surgical outcome of traumatic peripheral nerve injuries in the pediatric population</description><identifier>ISSN: 1016-2291</identifier><identifier>EISSN: 1423-0305</identifier><identifier>DOI: 10.1159/000484174</identifier><identifier>PMID: 29166638</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Child ; Female ; Hospitals ; Humans ; India ; Male ; Neurosurgical Procedures ; Original Paper ; Peripheral Nerve Injuries - epidemiology ; Peripheral Nerve Injuries - surgery ; Retrospective Studies ; Sciatic Nerve ; Time Factors ; Treatment Outcome</subject><ispartof>Pediatric neurosurgery, 2018-01, Vol.53 (2), p.94-99</ispartof><rights>2017 S. Karger AG, Basel</rights><rights>2017 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c306t-91e14ef9b443911a269809ea36e7de0f26b4750bc23311bfd083eb88e868dfcd3</citedby><orcidid>0000-0001-7613-1929</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,2423,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29166638$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Devi, Bhagavatula Indira</creatorcontrib><creatorcontrib>Konar, Subhas K.</creatorcontrib><creatorcontrib>Bhat, Dhananjaya I.</creatorcontrib><creatorcontrib>Shukla, Dhaval P.</creatorcontrib><creatorcontrib>Bharath, R.</creatorcontrib><creatorcontrib>Gopalakrishnan, M.S.</creatorcontrib><title>Predictors of Surgical Outcomes of Traumatic Peripheral Nerve Injuries in Children: An Institutional Experience</title><title>Pediatric neurosurgery</title><addtitle>Pediatr Neurosurg</addtitle><description>Aim: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). Materials and Methods: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. Results: Intramuscular injections were the most common cause (52.9%), followed by entrapment (15.6%). The most common nerve involved was the sciatic nerve (54.9%), followed by the common peroneal nerve (13.7%), the ulnar nerve (10.8%), and the radial nerve (10.8%). Perineural adhesion was the most common intraoperative finding (74.5%), followed by a neuroma in continuity (14.7%) and gap (10.8%). Most of the children with peripheral adhesion underwent external and internal neurolysis (75.5%). Follow-up was available for 67 children. The median follow-up period was 7 months (range 3-36). The outcome was assessed according to MRC grading. Favorable functional improvement was noted in 76.1% of the children. Age less than 10 years (p = 0. 06), injury before 6 months (p = 0.03), and MRC motor grade (<3) (p = 0. 01) were positive predictive factors related to the final outcome. Conclusion: Early surgical intervention, age less than 10 years, and incomplete motor palsy were the best predictors of a superior functional outcome. This study can serve as a guide to determine the epidemiology, duration of intervention, and surgical outcome of traumatic peripheral nerve injuries in the pediatric population</description><subject>Child</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>India</subject><subject>Male</subject><subject>Neurosurgical Procedures</subject><subject>Original Paper</subject><subject>Peripheral Nerve Injuries - epidemiology</subject><subject>Peripheral Nerve Injuries - surgery</subject><subject>Retrospective Studies</subject><subject>Sciatic Nerve</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1016-2291</issn><issn>1423-0305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo90E1PAjEQBuDGaATRg3dj9qiH1XZbuq03QlBJiJCI5023OwvF_cC2a_TfWwU5zWTmmTm8CF0SfEfIUN5jjJlgJGVHqE9YQmNM8fA49JjwOEkk6aEz5zYYByzZKeqFEeecij5qFxYKo31rXdSW0WtnV0arKpp3Xrc1_A2XVnW18kZHC7BmuwYbwAvYT4imzaazJjDTROO1qQoLzUM0asLCeeM7b9om4MnXNlxCo-EcnZSqcnCxrwP09jhZjp_j2fxpOh7NYk0x97EkQBiUMmeMSkJUwqXAEhTlkBaAy4TnLB3iXCeUEpKXBRYUciFAcFGUuqADdLP7u7XtRwfOZ7VxGqpKNdB2LiOSp4JjnohAb3dU29Y5C2W2taZW9jsjOPvNNzvkG-z1_m2X11Ac5H-gAVztwLuyK7AHsL__AbLjfwQ</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Devi, Bhagavatula Indira</creator><creator>Konar, Subhas K.</creator><creator>Bhat, Dhananjaya I.</creator><creator>Shukla, Dhaval P.</creator><creator>Bharath, R.</creator><creator>Gopalakrishnan, M.S.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7613-1929</orcidid></search><sort><creationdate>20180101</creationdate><title>Predictors of Surgical Outcomes of Traumatic Peripheral Nerve Injuries in Children: An Institutional Experience</title><author>Devi, Bhagavatula Indira ; Konar, Subhas K. ; Bhat, Dhananjaya I. ; Shukla, Dhaval P. ; Bharath, R. ; Gopalakrishnan, M.S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-91e14ef9b443911a269809ea36e7de0f26b4750bc23311bfd083eb88e868dfcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Child</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>India</topic><topic>Male</topic><topic>Neurosurgical Procedures</topic><topic>Original Paper</topic><topic>Peripheral Nerve Injuries - epidemiology</topic><topic>Peripheral Nerve Injuries - surgery</topic><topic>Retrospective Studies</topic><topic>Sciatic Nerve</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Devi, Bhagavatula Indira</creatorcontrib><creatorcontrib>Konar, Subhas K.</creatorcontrib><creatorcontrib>Bhat, Dhananjaya I.</creatorcontrib><creatorcontrib>Shukla, Dhaval P.</creatorcontrib><creatorcontrib>Bharath, R.</creatorcontrib><creatorcontrib>Gopalakrishnan, M.S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Devi, Bhagavatula Indira</au><au>Konar, Subhas K.</au><au>Bhat, Dhananjaya I.</au><au>Shukla, Dhaval P.</au><au>Bharath, R.</au><au>Gopalakrishnan, M.S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Surgical Outcomes of Traumatic Peripheral Nerve Injuries in Children: An Institutional Experience</atitle><jtitle>Pediatric neurosurgery</jtitle><addtitle>Pediatr Neurosurg</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>53</volume><issue>2</issue><spage>94</spage><epage>99</epage><pages>94-99</pages><issn>1016-2291</issn><eissn>1423-0305</eissn><abstract>Aim: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). Materials and Methods: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. Results: Intramuscular injections were the most common cause (52.9%), followed by entrapment (15.6%). The most common nerve involved was the sciatic nerve (54.9%), followed by the common peroneal nerve (13.7%), the ulnar nerve (10.8%), and the radial nerve (10.8%). Perineural adhesion was the most common intraoperative finding (74.5%), followed by a neuroma in continuity (14.7%) and gap (10.8%). Most of the children with peripheral adhesion underwent external and internal neurolysis (75.5%). Follow-up was available for 67 children. The median follow-up period was 7 months (range 3-36). The outcome was assessed according to MRC grading. Favorable functional improvement was noted in 76.1% of the children. Age less than 10 years (p = 0. 06), injury before 6 months (p = 0.03), and MRC motor grade (<3) (p = 0. 01) were positive predictive factors related to the final outcome. Conclusion: Early surgical intervention, age less than 10 years, and incomplete motor palsy were the best predictors of a superior functional outcome. This study can serve as a guide to determine the epidemiology, duration of intervention, and surgical outcome of traumatic peripheral nerve injuries in the pediatric population</abstract><cop>Basel, Switzerland</cop><pmid>29166638</pmid><doi>10.1159/000484174</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7613-1929</orcidid></addata></record> |
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subjects | Child Female Hospitals Humans India Male Neurosurgical Procedures Original Paper Peripheral Nerve Injuries - epidemiology Peripheral Nerve Injuries - surgery Retrospective Studies Sciatic Nerve Time Factors Treatment Outcome |
title | Predictors of Surgical Outcomes of Traumatic Peripheral Nerve Injuries in Children: An Institutional Experience |
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