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https://doi.org/10.14300/mnnc.2023.18064

The use of an epineurial prosthesis and direct electrical stimulation in the treatment of traumatic intra-trunk injuries of the median nerve

[Original research] [Neurology]
Anna Viktorovna Zorkova; Vera Naumovna Grigorieva; Sergei Karpov;

The efficiency of the therapeutic use of synthetic epineural coating in combination with electrical stimulation of the median nerve in its injuries without a complete anatomical break has been studied. The 43 patients with intra-trunk damage of the median nerve in the lower third of the forearm were examined. From them the 22 patients underwent external neurolysis of the median nerve, 21 patients underwent external nerve neurolysis with the additional use of a synthetic (made of hydrophobic acrylic) epineurium simulator in combination with its electrical stimulation. Surgical treatment using the artificial epineurium prosthesis and direct electrical nerve stimulation resulted in a statistically more significant restoration of hand muscle strength and restoration of arm function in the first six months after the intervention compared with isolated external neurolysis. The use of synthetic epineural coating in combination with neurolysis and electrical stimulation demonstrated an increase in the effectiveness of the treatment of patients with traumatic intra-trunk injuries of the median nerve.

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Keywords: traumatic nerve injuries, median nerve, neurolysis, epineural prosthesis, subepineural nerve stimulation