Ivakhnenko D. Features of current and treatment tactics of traumatic injuries of peripheral nerves of the patients of elderly and senile age

The dissertation is devoted to urgent neurosurgery questions in traumatic damages of peripheral nerves of the patients, whose age exceeds 60 years. The reason and mechanisms of traumas, and also their densities in frame of damages of nerves were revealed on the basis of studying results of inspection and microsurgical treatment 119 patients of elderly and senile age (average age 64,5 years) with injuries of peripheral nerves. The control group included 60 middle-aged patients (average age 52,5 years). Characteristics feature of clinical current of traumas of peripheral nerves for the old patients was the early appearance of trophic infringements and proof painful symptoms. It was settled, that the final results of neurosurgical treatment of peripheral nerves' damages at the patients of the old age category are worse that the results of treatment of the middle-aged patients. It was proved, that tactics of treatment of traumatic damages of peripheral nerves at the geriatric aged patients should have individual differentiated character with compulsory including of the factors: degrees of gravity of accompanying damages, clinic neurology and electroneuromiografy dates, interoperation diagnostics, macro and microscopic changes in uninjured site of nerve fibber's. The clinic and electroneuromiografy indications and contraindications to reconstructive operations on nervous trunks were clarified in the group of elderly patients. The optimum terms for operative treatment were determined. The indications to application of reductive orthopaedic methods of treatment were proved and added, that considerably raised the effectiveness of surgical treatment.