[The suture technic for damaged peripheral nerves].

The outcomes of traditional epineural, microsurgical epineural and interfascicular sutures of the median and ulnar nerves in the lower third of the forearm were compared in children. Evidence is provided for the differential approach to applying an interfascicular and microsurgical epineural suture, as well as for limitations in the use of an interfascicular suture. The authors show it necessary to make investigations to clarify whether the fascicles on the ends of a diseased nerve may be more validly identified and whether the studies into connective and nerve tissue relationships in the suture line.

[Nerve damages to the lower extremity in children and the possibilities for their surgical treatment].

Examination of 49 children with injuries to the nerves of the lower extremity showed that trauma was inflicted most frequently to the common peroneal and the deep or superficial peroneal nerve. The outcomes of surgical treatment are often poor because of delayed hospitalization for surgical management, imperfect surgical techniques, and anatomicophysiological features of the peroneal nerves.

[Differences in blood flow in injured nerves in children and adults].

The investigation of blood flow in injured nerves in 14 patients by the method of hydrogen clearance has revealed substantial difference of the blood flow value in children and adults. The authors consider that it may be of significance for the interpretation of differences in the course of regeneration in patients of different age.

[Cranial nerve injuries in children].

Eleven children with injuries to the cranial nerves were examined. It has been revealed that as a result of surgical interventions, the facial nerve gets affected more frequently. The results of the treatment often appear unsatisfactory because of the late referral of the victims to hospitals for operative treatment.

[Combined injuries to the nerves and vessels in children].

It is shown on the basis of comparative analysis of 39 cases with combined injuries of the nerves and vessels in children that the main blood flow must be restored even in compensated circulation in the limb; this improves regeneration of the nerve and lessens the delay in the growth of the limb. The time of the intervention is determined by the degree of ischemia of the limb and the existence of special conditions.

[Autoplasty in nerve injuries in children].

A comparative assessment of results of autoplasty and the epineural suture in 32 cases was made on the basis of a well-known scores system. It was established that under similar or close conditions influencing the regeneration the results proved to be the same in both groups. It suggests that the epidural suture is the method of choice in those children where it is not associated with technical difficulties.

[Recovery of movement and sensation after suturing the median and ulnar nerves of children and adults].

A clinical study of 32 children and 136 adults followed up for 1 month to 5 years and more after an epineural suture has shown that in children the restoration of movements and sensitivity is 1.5-2 times faster than in adults. Motor function is restored to a fairly good extent in over 60% of both children and adults.

[Surgical treatment of partial injuries of peripheral nerves].

A surgical microscope and microsurgical instruments were used in operations on 37 patients with incomplete injuries to the median, ulnar, sciatic, and peroneal nerves. It is shown that microsurgical techniques make it possible to improve the results of treatment because in some cases only the injured bundles are repaired while the intact bundles are preserved. In some cases the operation cannot be performed even by microsurgery techniques because of coarse changes within the nerve trunk.