Injury · 2025
Early surgical intervention in combat-related peripheral nerve injuries: Lessons from a consecutive cohort from the 2023-2024 Israel-Hamas war.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lachnish Jordan, Seltser Anna, Steinberger Zvi, Palti Ram, Sherf Matan, Tilbor Ido, Lahham Firass, Biran Mattan, Khadija Amir, Arami Amir
Аннотация
PURPOSE: Combat-related peripheral nerve injuries (CRPNIs) are frequently associated with significant long-term disability. While conventional practice often favors delayed exploration to avoid unnecessary interventions, emerging evidence supports early intervention.
METHODS: We retrospectively reviewed 184 patients (265 CRPNIs) treated during the first ten months of the 2023-2024 Israel-Hamas war. Collected data included demographics, injury details, surgical timing, intraoperative findings, procedures performed, and postoperative complications. Surgical Explorations were considered positive if partial/complete nerve transection or nerve compression (e.g., by shrapnel or bone fragment) were found.
RESULTS: Of 184 patients, 136 (74%) underwent nerve exploration at a median of 8 days post-injury, with positive findings in 72% of these cases. Definitive nerve procedures (DNP), such as direct repair or graft reconstruction, were performed in 48% of explored cases, yielding a 5% perioperative complication rate. Early DNP recipients had significantly fewer secondary nerve procedures than those managed nonoperatively (19% vs. 38%, p=0.01).
CONCLUSIONS: Early surgical exploration in CRPNIs demonstrated a high rate of actionable findings and reduced the subsequent need for surgical interventions, supporting a more aggressive initial approach. Further studies are warranted to determine long-term functional outcomes.
METHODS: We retrospectively reviewed 184 patients (265 CRPNIs) treated during the first ten months of the 2023-2024 Israel-Hamas war. Collected data included demographics, injury details, surgical timing, intraoperative findings, procedures performed, and postoperative complications. Surgical Explorations were considered positive if partial/complete nerve transection or nerve compression (e.g., by shrapnel or bone fragment) were found.
RESULTS: Of 184 patients, 136 (74%) underwent nerve exploration at a median of 8 days post-injury, with positive findings in 72% of these cases. Definitive nerve procedures (DNP), such as direct repair or graft reconstruction, were performed in 48% of explored cases, yielding a 5% perioperative complication rate. Early DNP recipients had significantly fewer secondary nerve procedures than those managed nonoperatively (19% vs. 38%, p=0.01).
CONCLUSIONS: Early surgical exploration in CRPNIs demonstrated a high rate of actionable findings and reduced the subsequent need for surgical interventions, supporting a more aggressive initial approach. Further studies are warranted to determine long-term functional outcomes.