The human nervous system is the brain, the spinal cord, the autonomic nervous system and the peripheral nervous system. Messages are messages that transmit messages from the brain to the various parts of the body and carry stimuli from various parts of the body to the brain. It's like phone cords. The nerves are the motor nerves that carry messages to the muscles of the brain and control the movements, and the sensory nerves that carry sensations like pain, pressure, temperature from various parts of the body. The sensory nerves communicate with the brain, and in response to these stimuli transmitted from the brain to the muscles of the peripheral motor nerves.
For example, when we want to move our index finger, the brain sends an order to the muscles that will move our index finger through the peripheral nerves to the spinal column, and the muscles contract to move the finger. The nerves within the peripheral nerve reach the body with the help of fibers called axons that can reach up to one meter long. This whole thing happens in about a tenth of a second.
Peripheral nerve injury and healing
Recovery in brain and spinal cord injuries is very limited, but the peripheral nerve has a higher recovery potential. This process sometimes lasts for months. In this process, the muscles have a melting called atrophy. It is very important that this time factor is known. Patients should be patient, do not lose hope, and passively exercise to keep the joint in motion.
The history of the patient
The injuries and complaints of the patient should be questioned and detailed information should be obtained with the mechanism of the injury.
The level of the peripheral nerve is determined by performing force and sensory examination.
Electromyelography (EMG) gives detailed information about the level and degree of the nervous problem. The patient is scheduled for treatment according to the level and damage status determined in EMG.
Causes and Mechanisms Related to Peripheral Nerve Damage:
1. Closed Trauma: Sudden injury in the form of compression and tension. The continuity of nerves is preserved.
2. Open Lacerations Trauma: Sharp or blunt trauma
It is concerned. It causes complete or incomplete nerve injury.
3. Firearm Injuries: The continuity of nerve structure is often protected
4. Damsal trauma and ischemia: the feeding of nerve tissue due to vascular injury is disturbed.
5. Chronic Traumas: nerve damage caused by long periods of pressure and tension.
Carpal Tunnel Syndrome (nerve compression in palm and blade):
Peripheral nerve entrapment is the most common neuropathy. The frequency in society is 1%. It's more common in females. Findings and complaints in the majority of patients are between the ages of 40-60. The main symptoms are pain, burning, tingling and numbness localized to the first three fingers of the hand. The median is squeezed as a result of the ligament thickening that crosses it in the nerve wrist. Generally, there are complaints of bass, signs and middle numbness and pain. Tired use of the hand increases the symptoms. These ; knitting, using computers, writing articles, washing dishes, working in the garden, etc.
Patients usually do not benefit from treatments applied outside of surgery, and the nerve is relaxed surgically by cutting the ligament.
Various surgical techniques are available. In the technique with small incision in the palm, the nerve is seen directly and the nerve is released by cutting the ligament on it
Another technique is to cut the ligament using an endoscope.
Tired use of the hand increases the symptoms. These ; knitting, using computers, writing articles, washing dishes, working in the garden, etc.
Indications for non-surgical treatment;
1) the duration of symptoms is short,
2) moderate or intermittent symptoms,
3) cases where symptoms are expected to pass
Conservative treatment; pain relievers.
Indications for surgical treatment;
1) inadequacy in conservative treatment
2) typical clinical findings confirmed by tests,
3) sensory loss, atrophy or weakness.
Surgery: Transverse carpal ligament excision under local anesthesia
Ulnar Trap Neuropathy
Kubital tunnel syndrome causes problems such as pain, swelling, numbness and loss of power as a result of a compression or exposure of the ulnar nerve, one of the three major nerves of the hand. The nerve runs between the two starting points of the muscles that bend our wrist through the two bony protrusions in our elbow. This area is vulnerable to pressure and trauma because the nerve is very superficial.
Treatment should generally avoid behaviors that cause it. The surgeon is made in two ways: First, the ulnar groove is opened and the nerve is relaxed or the ulnar nerve is replaced
Peroneal Nerve Trap Neuropathy
Peroneal Nerve Jam occurs with the compression of the fibula near the neck of the bone near the string of the given name. Trauma is seen as a cause in these patients. Leg under the knee