PERIPHERAL-NERVE INJURIES IN A 3RD-WORLD COUNTRY

This five year prospective research study reports on 74 patients with injuries to 89 nerve segments. Ninety eight pc of the injuries were ca used by penetrating and only four pc by blunt trauma; 5,4 pc of the pa tients presented directly to us as emergencies while the remainder pre sented after an average delay of 23 weeks. Clavioaxillary (40,5 pc) an d upper limb (41,9 pc) neurological lesions constituted the bulk of th e injuries involving a predominantly younger male population (96 pc). Brachial plexus and proximal upper limb injuries often involved more t han one segment of a nerve, 34,9 pc of the lesions were axonotmetic, r equiring external and internal neurlyses, while 65,1 pc were neurotmer ic, for which neurorrhaphy (in four patients) or sural nerve interposi tion grafting was performed. The follow up compliance was poor. At two years, with a 55,4 pc re-attendance rate, improvement to at least gra de three or more, was achieved in 50 pc of the attending patients, neu rolysed for axonotmesis and in 53,8 pc of the neurotmetic patients who required sural grafts. At five years the re-attendance rate had falle n to 16,2 pc and this did not offer a realistic clinical and statistic al generalisation of the results.