Finger flexor tendons and nerves at the level of the lower third of the forearm and wrist joint are so close that isolated tendon damage without simultaneous damage to nerve trunks is relatively rare. In this regard, in order not to stitch one of the ends of the nerve with the tendon with a wet gauze ball, a blood clot is carefully removed from the plane of the transverse section of the tendon and nerve. After this, the difference in their color and structure is clearly revealed: the tendons have a pearly yellowish color, shiny, nerve trunks accompanied by blood vessels – grayish in color, matte.
First, sutures are laid on the tendons, and then epineural sutures are placed on the freshened ends of the crossed nerve.
The outcome of nerve damage is determined primarily by the condition of the nerve itself, the adequacy of resection of the damaged areas and the accuracy of matching the ends when suturing. The final results of suturing of the nerve suture are determined only a few years after the operation. In the coming months after surgery, only the initial signs of nerve regeneration can be noted.
Treatment of damage to nerve trunks
First aid on the battlefield (at the lesion site) for gunshot (closed) lesions of the nerve trunks of the limbs is provided in accordance with the nature of only the limb injury. In case of a gunshot wound (fracture) of an extremity, an aseptic dressing is applied to the wound, bleeding stops according to indications, limb transport immobilization is performed according to general rules, painkillers are injected from a syringe tube. Giving tablet antibiotics. Evacuation to the BCH.
Pre-medical care
The volume of pre-medical care is the generally accepted measures for providing assistance in case of injuries (injuries) to the extremities, improve (correct) the previously applied dressing, perform transport immobilization with time means, check the correctness of applying the tourniquet, the wounded person receives painkillers, antibiotics, etc. Evacuation to the MPP .
First aid
Medical sorting of the wounded into a limb is carried out but according to the general rules for this localization of injuries: 3 groups of wounded are distinguished. The MPP doctor does not always detect damage to the peripheral nerve of the limb, since disturbances in the movements of the limb can be caused by both a fracture and damage (injury) to the soft tissues of the limb. A comprehensive assessment of the nature of the wound (injury), the projection of the wound channel and the study of limb sensitivity help to establish a preliminary diagnosis – nerve damage. Special measures of medical care in case of damage to the peripheral nerves in the MPP: conductor or sheath novocaine blockade of the damaged nerve trunk, limb immobilization by means of transport immobilization, administration of painkillers (morphine). Other therapeutic measures are common for other injuries (injuries) to the limbs.