Tiến sĩ Mohler là nghiên cứu sinh, mục của tay và phẫu thuật Microvascular, Sở Chỉnh hình và Thể thao Y học, Đại học Washington, Seattle, WA. Tiến sĩ Hanel là Giáo sư, Mục tay và Microvascular phẫu thuật, Khoa Chỉnh hình và Thể thao Y học, Đại học Washington, Seattle. Không ai trong số các tác giả sau đây hoặc các phòng ban mà họ là chi nhánh | Closed Fractures Complicated by Peripheral Nerve Injury L. Randall Mohler MD Douglas P. Hanel MD Dr. Mohler is Fellow Section of Hand and Microvascular Surgery Department of Orthopaedics and Sports Medicine University of Washington Seattle WA. Dr. Hanel is Professor Section of Hand and Microvascular Surgery Department of Orthopaedics and Sports Medicine University of Washington Seattle. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article Dr. Mohler and Dr. Hanel. Reprint requests Dr. Hanel Department of Orthopaedics and Sports Medicine University of Washington Box 359798 325 Ninth Avenue Seattle WA 981042499. J Am Acad Orthop Surg 2006 14 32-37 Copyright 2006 by the American Academy of Orthopaedic Surgeons. Abstract Closed fractures may be complicated by associated peripheral nerve injury. However because clinical information is limited determining the best course of treatment is difficult. Most patients with closed fractures have a local nerve injury without nerve division their prognosis for recovery is favorable. In the acute setting immediate surgery is usually unwarranted because of the difficulty in accurately defining the severity and extent of nerve injury. When débridement of an open fracture or repair is not required peripheral nerve injuries are best observed and the extremity treated with splinting and exercise to prevent loss of joint motion. Patients who fail to demonstrate signs of recovery at 6 months either clinically or with electrodiagnostic testing should undergo exploration to maximize the likelihood for return of function. When during exploration the nerve is in continuity intraoperative measurement of nerve action potentials should be done. Measuring nerve action potentials will determine whether nerve grafting local neurolysis or excision of the injured segment .
