The application of combined electrostimulation under isolated and comorbide injuries of peripheral nerves of upper and lower extremities

The technique of combined implantation of electrodes at the same time instant with osteosynthesis by Ilizarov device is applied in The G.A. Ilizarov Russian research center “The restoring traumatology and orthopedics”. In 2001-2013, the neurosurgery department treated 330 patients with traumatic injuries of peripheral nerves who underwent puncture direct electrostimulation (group of patients I). The results were analyzed concerning operative treatment of 80 patients with combine injury of nerve stem and tubular bone (group of patients II). The courses of electrostimulation by low intensive alternating current through implanted electrodes and cutaneous leads. The good results of treatment were obtained in 76.96% of cases in patients from group I. During the first year after treatment the amplitude of M-responses (A=MR) characterized by expressed positive dynamics i.e. up to fourfold increasing of indicator (p<0.01). The values of average amplitude of total electromyogram increased relatively to previous date of examinations up to 180.1% (p<0.001). In the group II, good results of treatment were obtained in 67.5% of patients. During one year after termination of course of electrostimulation the further increasing of values A=MR was noted related to previous date of examinations up to 52.1%. According criterion of average amplitude of total electromyogram the increase consisted 87%. The results permit made a conclusion that direct electrostimulation of nerve stems by alternating current under combined impact on injured structures is an effective one.

injury, nerve stem, tubular bone, post-traumatic neuropathy, ulnar nerve, radial nerve, median nerve, sciatic nerve, femoral nerve, peroneal nerve, tibial nerve