Kirurško liječenje ozljeda brahijalnog pleksusa

master's thesis

• Title (english): Surgical treatment of brachial plexus injuries
• Author: Zlatan Ibradžić
• Mentor: Srećko Budi (mentor)
• Committee member: Rado Žic (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Srećko Budi (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Ozljede brahijalnog pleksusa su kompleksna medicinska stanja koja u većini slučajeva uzrokuju velike funkcionalne probleme za pacijente. Iz brahijalnog pleksusa izlaze svi živci koji inerviraju gornji ud, motorički i senzorno, poput nervusa radialisa, ulnarisa i medianusa. Kao ozljede, danas se najčešće javljaju u prometnim nesrećama, sa posebnim naglaskom na motociklističke nesreće. Ovisno o tome koji dio brahijalnog pleksusa je ozlijeđen, pacijenti imaju funkcionalni nedostatak rada pojedine skupine mišića gornjeg uda, počevši od neuroloških ispada i disfunkcije mišića šake, do nemogućnosti fleksije lakta, rotacije ramena i sl. Ozljede brahijalnog pleksusa najčešće se dijele na supraklavikularne i infraklavikularne i ovisno o lokaciji ozljede može se odmah pretpostaviti koji živci su ozlijeđeni. Iznimno je važno napraviti neurološki fizikalni pregled, te RTG i MRI, kao ključni alat koji nam pomaže u dijagnostici ozljede brahijalnog pleksusa. Kirurško liječenje ozljeda brahijalnog pleksusa je nužno za povrat funkcije mišića ozlijeđenoga uda i najbolje je pristupiti operaciji unutar prvih 6 mjeseci od ozljede. Denervirani mišići ruke sa vremenom atrofiraju i stoga je njihova reinervacija glavni cilj operacije, bilo to popravkom oštećenog živca ili prijenosom novog živca. Zahvaljujući modernog kirurgiji, posebice mikrokirurgiji, kirurzi danas imaju mnogobrojne opcije popravka živaca brahijalnog pleksusa, među kojima se kao najbolje metode ističu direktno šivanje živaca (neurorafija), nerve grafting i transfer živaca iz drugih dijelova tijela.

Abstract (english)

Brachial plexus injuries are complex medical conditions that in most cases cause major functional problems for patients. From the brachial plexus, all the nerves that inerve the upper limb are excited, motorically and sensitively, such as radial nerves, ulnaris and medianus. Brachial plexus injuries today most often occur in traffic accidents, with special emphasis on motorcycle accidents. Depending on which part of the brachial plexus is injured, the patients have functional disadvantages of a particular group of arm muscles, starting from neurological defects and muscle dysfunction, to the unability of elbow flexion, shoulder rotation, and others. Brachial plexus injuries are most commonly divided into supraclavicular and infraclavicular, and depending on the location of the injury, one can immediately assume which nerves are injured. It is extremely important to do a neurological examination, as well as RTG and MRI, as a key tool that helps us diagnose pectoral injury. Surgical treatment of brachial plexus injury is necessary to restore the muscle function of the injured arm and it is best to approach the operation within the first 6 months of the injury. Denervated hands muscles tend to atrophy over time and therefore their reinvention is the main goal of surgery, whether by repairing a damaged nerve or by transferring a new nerve. Thanks to modern surgery, especially microsurgery, surgeons today have many options for repairing the nerves, among which the best methods are the direct sewing of nerves (neurorrhaphy), nerve grafting and nerve transfer from other parts of the body.

• Keywords: brahijalni pleksus; ozljede; kirurško liječenje
• Keywords (english): brachial plexus; injuries; surgical treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:875516
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta je unio ključne riječi.
• Created on: 2019-01-09 09:18:57