Expert opinion on the article Govenko F.S., Snischuk V.P., Klimkin A.V., Maletsky E.Yu. "Closed injuries of the median nerve in children: tactics, variants of surgery"

Abstract

Bone fractures in the upper extremities occupy one of the first places in the structure of pediatric trauma. One of the serious complications after such injury is damage to blood vessels and nerves. Closed injury of nerve trunks is most common. The rate of nerve damage and various risk factors are sufficiently described in literary sources; however, these publications are uncoordinated. Up to now, there is no any reasonable algorithm for managing patients with closed injuries of nerve trunks. The choice of curative tactics – conservative or surgical – depends on the opinion of individual author. Though most closed nerve injuries recover spontaneously, there is a percentage of cases when a timely surgical intervention is a must. Diagnostic findings, such as after electroneuromyography (ENMG), are not always correctly interpreted by clinicians and only indirectly determine the time of surgical intervention. In our discussion, we have decided to develop this topic in more details.