Neurolyses of the brachial plexus and peripheral nerves of the extremities

AIM This study presents the results of the brachial plexus and the peripheral extremities nerves neurolyses conducted in our clinic for 18 years from 1985 to 2003. SUBJECTS AND METHODOLOGY 92 patients were treated surgically using neurolyses. Out of this number, 10 of them concerned brachial plexi, 49 nerves of the upper extremities and 33 nerves of the lower extremities. Out of the total patient number, 67 were males and 25 females, aged 30 years on average. The average time gap between the injury and the surgical procedure was 6.9 months. An extremely long time gap (over 12 months) was recorded in 5 cases. The operations were conducted in patients who suffered from a complete or persisting neurological deficits. In 92 patients, external neurolysis was conducted, out of them in 7 cases also internal neurolysis was conducted. Cases which required resection of the fascicles and reconstruction using autotransplants, as well as cases which had already undergone reconstruction procedures, have not been included in this study. The results analysis has been conducted with respect to the time gap between the surgical procedure and the injury, to the patient's age, to the type of the injured nerve and to the peroperatively detected degree of fibrotic changes. RESULTS The best results were observed in patients under 20 years of age, in cases of early treatment, in distal injuries and in neurolyses of the tibial and radial nerves. CONCLUSION When indicated, the early surgical treatment is the main factor determining the results of the surgical procedures.