Preventing nerve damage after an accident<\/p>\n
Maria Endah Hulupi, The Jakarta Post, Jakarta<\/p>\n
While injuries from traffic accidents, especially those from
\nmotorcyclists, are an everyday occurrence on Jakarta streets, few
\nvictims seek help from a specialist in nerve injury treatment.<\/p>\n
Some people are simply ignorant about the importance of the
\ntreatment; for others, it may be a concern about the cost.
\nBut if such a nerve injury is left untreated, the people may
\nsuffer permanent injury, such as to the arms, elbows or shoulder,
\nneurosurgeon Daniel Kim warned.<\/p>\n
\"Very often a patient comes to the doctor, holding his arm
\nbecause he has no arm movement,\" said the director of the
\nneurosurgical department of Stanford University in the U.S. in a
\nrecent seminar on brain and spine management, organized by Pantai
\nIndah Kapuk Hospital in North Jakarta.<\/p>\n
The brachial plexus is a complex network of nerves,
\ncontrolling movements of the chest, shoulders and arms. It is
\noften damaged when traffic-accident victims injure the lower part
\nof the shoulder.<\/p>\n
When treating a patient with brachial plexus injury, doctors
\nmust understand the anatomy of the nerve system when conducting
\nthe examination. Following examination, the doctors need to
\nquickly assess the level of injury and what nerves have been
\ninvolved.<\/p>\n
\"It is not just a brachial plexus injury, because there are
\ndifferent elements and components of a brachial plexus,\" Kim
\nsaid.<\/p>\n
Most brachial plexus injuries in this country are due to
\nstreet accidents. But Kim added that such injuries can also be
\ncaused by knife and gunshot wounds, and can also occur during the
\ndelivery process, when an obstetrician grabs the baby by its
\nshoulder or arms to pull it out of the mother's womb, causing a
\nstretch injury, called brachial plexus palsy.<\/p>\n
It can also be a side effect of radiation therapy, especially
\nfor breast and lung cancer treatments.<\/p>\n
\"In Indonesia, people with brachial plexus injuries,
\nespecially those caused by street accidents, are referred to an
\northopedist ... but not to a neurosurgeon,\" Alfred Soetrisno, a
\nneurosurgeon with the hospital, said on the sidelines of the
\nseminar.<\/p>\n
The hospital's senior director, Satyanegara, also explained
\nthat most patients do not receive proper treatment because the
\ntreatment is complicated and many hospitals still lack the
\nequipment required to ensure good results.<\/p>\n
\"It depends on the injury... but when the injured receives
\nproper and timely treatment, his or her chance to recover is
\ngood,\" he said.<\/p>\n
In the United States, Kim said, surgical treatment for
\nbrachial plexus injuries is performed by a neurosurgeon.<\/p>\n
He performed a cadaver dissection at the seminar to identify
\nthe location of the nerves, which he started by making a z-shaped
\nincision on the upper right shoulder.<\/p>\n
Kim said that the severed nerve can be reconnected by making a
\nnerve graft repair, using the sural nerve from the leg area.
\n\"This is very common and after the surgery, the patient will walk
\njust fine.\"<\/p>\n
Another option is to take a nerve graft from the arm area.<\/p>\n
\"We don't recommend neurosurgeons take motoneurons since
\nthey're will paralyze certain parts of the arm. So (it is
\nadvisable to) take cutaneous nerve,\" he said.<\/p>\n
While some brachial plexus injuries do not need treatment as
\nthey will heal on their own, Kim also stressed the importance of
\ntimely treatment.<\/p>\n
\"If the injury is one year old or older, the chance for
\nrecovery is very small since the muscles become atrophied and
\nthere will be very little functional recovery that can occur,\" he
\nsaid.<\/p>\n
After the surgery, Kim recommended physical therapy begin as
\nearly as possible.<\/p>\n
\"Even (the therapy should start) within the first week after
\nsurgery, because when a patient has paralysis in his arm and he
\ndoesn't move it, he will develop a frozen shoulder and elbow. His
\ntendon becomes contracted so he will develop a tendon
\ncontracture.\"<\/p>\n
He also advised patients to regularly open their fingers and
\nexercise them so they do not develop a \"claw\", or rigid, hand.<\/p>\n
Success of the recovery depends on the age of the patient and
\nthe nerves involved.<\/p>\n
Kim explained that the nerves of children regenerate faster
\nthan those of adults. Also, some nerves in the deltoid, triceps
\nand biceps recover faster than those of finger muscles, for
\nexample.<\/p>\n
\"Based on our experience, the recovery could take as long as
\ntwo to five years,\" he said.<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/preventing-nerve-damage-after-an-accident-1447893297",
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