Search Results
Search for other papers by Petros Mikalef in
Google Scholar
PubMed
Search for other papers by Dominic Power in
Google Scholar
PubMed
-
Neurectomy is one of the treatments available to the surgeon treating patients with spasticity of the upper limb.
-
Its popularity has increased in recent years.
-
Accurate knowledge of the anatomical variations of the terminal branches to the muscles is required in order to achieve a successful outcome.
-
Although the anatomy has been thoroughly studied, there are still controversies regarding the percentage of the nerve to be resected for a successful result, and also regarding the terminology that has been used in the literature to describe the procedure.
-
The literature for neurectomies for the upper limb is reviewed and an agreement regarding terminology is proposed.
Cite this article: EFORT Open Rev 2017;2:469-473. DOI: 10.1302/2058-5241.2.160074
Search for other papers by Duncan Avis in
Google Scholar
PubMed
Search for other papers by Dominic Power in
Google Scholar
PubMed
-
Axillary nerve injury is a well-recognized complication of glenohumeral dislocation. It is often a low-grade injury which progresses to full recovery without intervention. There is, however, a small number of patients who have received a higher-grade injury and are less likely to achieve a functional recovery without surgical exploration and reconstruction.
-
Following a review of the literature and consideration of local practice in a regional peripheral nerve injury unit, an algorithm has been developed to help identification of those patients with more severe nerve injuries.
-
Early identification of patients with high-grade injuries allows rapid referral to peripheral nerve injury centres, allowing specialist observation or intervention at an early stage in their injury, thus aiming to maximize potential for recovery.
Cite this article: EFORT Open Rev 2018;3:70-77. DOI:10.1302/2058-5241.3.170003.
Search for other papers by Timothy Bage in
Google Scholar
PubMed
Search for other papers by Dominic M. Power in
Google Scholar
PubMed
-
Nerves may be inadvertently injured during trauma surgery due to distorted anatomy, traction applied to a limb, soft tissue retraction, by power tools, instrumentation and from compartment syndrome. Elective orthopaedic surgery has additional risks of joint dislocation for arthroplasty surgery, limb lengthening, thermal injury from cement and direct injury from peripheral nerve blocks.
-
The true incidence is unknown, and many cases are diagnosed as neurapraxia with the expectation of a full and timely recovery without the need for intervention. The incorrect assignation of a neurapraxia diagnosis may delay treatment for a higher grade of injury and in addition fails to recognize that a diagnosis of neurapraxia should be made with caution and a commitment to regular clinical review. Untreated, a neurapraxia can deteriorate and result in axonopathy. The failure to promptly diagnose such a nerve injury and instigate treatment may result in further deterioration and expose the clinician to medicolegal challenge.
-
The focus of this review is to raise awareness of iatrogenic peripheral nerve injuries in orthopaedic limb surgery, the importance of regular clinical examination, the role of investigations, timing and nature of interventions and also to provide a guide to when onward referral to a specialist peripheral nerve injury unit is recommended.
Cite this article: EFORT Open Rev 2021;6:607-617. DOI: 10.1302/2058-5241.6.200123
Search for other papers by Deepak Samson in
Google Scholar
PubMed
Search for other papers by Chye Yew Ng in
Google Scholar
PubMed
Search for other papers by Dominic Power in
Google Scholar
PubMed
-
Traumatic knee dislocation is a complex ligamentous injury that may be associated with simultaneous vascular and neurological injury.
-
Although orthopaedic surgeons may consider CPN exploration at the time of ligament reconstruction, there is no standardised approach to the management of this complex and debilitating complication.
-
This review focusses on published evidence of the outcomes of common peroneal nerve (CPN) injuries associated with knee dislocation, and proposes an algorithm for the management.
Cite this article: Deepak Samson, Chye Yew Ng, Dominic Power. An evidence-based algorithm for the management of common peroneal nerve injury associated with traumatic knee dislocation. EFORT Open Rev 2016;1:362-367. DOI: 10.1302/2058-5241.160012.
Search for other papers by Abdus S. Burahee in
Google Scholar
PubMed
Search for other papers by Andrew D. Sanders in
Google Scholar
PubMed
Search for other papers by Dominic M. Power in
Google Scholar
PubMed
-
Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release.
-
Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation.
-
Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points.
-
Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery.
-
Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment.
Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135
Search for other papers by Abdus S. Burahee in
Google Scholar
PubMed
Search for other papers by Andrew D. Sanders in
Google Scholar
PubMed
Search for other papers by Colin Shirley in
Google Scholar
PubMed
Search for other papers by Dominic M. Power in
Google Scholar
PubMed
-
Cubital tunnel syndrome (CuTS) is the second most common compression neuropathy of the upper limb, presenting with disturbance of ulnar nerve sensory and motor function.
-
The ulnar nerve may be dynamically compressed during movement, statically compressed due to reduction in tunnel volume or compliance, and tension forces may cause ischaemia or render the nerve susceptible to subluxation, further causing local swelling, compression inflammation and fibrosis.
-
Superiority of one surgical technique for the management of CuTS has not been demonstrated. Different techniques are selected for different clinical situations with simple decompression being the most common procedure due to its efficacy and low complication rate.
-
Adjunctive distal nerve transfer for denervated muscles using an expendable motor nerve to restore the axon population in the distal nerve is in its infancy but may provide a solution for severe intrinsic weakness or paralysis.
Cite this article: EFORT Open Rev 2021;6:743-750. DOI: 10.1302/2058-5241.6.200129
