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Fulltext Nerve injuries in anterior shoulder dislocations

Yeap JS, Lee DJK, Fazir M, Kareem BA, Yeap JK

Med J Malaysia, 2004 Oct;59(4):450-4.
PMID: 15779576

A retrospective study was conducted to determine the incidence of nerve injuries in anterior dislocations of the shoulder and to determine if a neurological examination is routinely performed in such cases. One hundred and fifteen shoulder dislocations in 100 patients (74 males, 26 females; mean age 35+/-18 years) were reviewed. Eighty-seven patients were examined for neurological injuries prior to reduction and 8 of these patients (9.2%) were found to have sustained neurological injuries. Following reduction, neurological examination was performed in 85 patients. Three patients who were not examined initially prior to reduction were subsequently found to have nerve injuries after reduction. Seven patients (7%) were not examined for neurological injury both before and after reduction of the dislocation. Eleven patients were found to have sustained nerve injuries in the final analysis. Axillary nerve injuries were the most common, occurring in 8 patients. In conclusion, nerve injuries are common in shoulder dislocations. The importance of performing and documenting the findings of neurological examination anterior shoulder dislocations needs to be reiterated.

Matched MeSH terms: Peripheral Nerve Injuries*
Fulltext Approximate estimation of the condition of denervated muscle by studying intensity duration curves

Myint K, Nwe HH, Kanagasuntheram R

Med J Malaysia, 1982 Jun;37(2):175-9.
PMID: 7132838

Morphological and neuroelectrical changes of the skeletal muscle fibres after various types of injury to the nerve was studied in monkey. The percentage of normal and atrophic muscle fibres after various types of injury to the nerve was compared with the proportion of innervated and denervated muscle as shown by the position of the bend (kink) on the I.D. at corresponding stages. It was found that the pattern and the position of the I.D. curve when considered together only gave an approximate estimation of the proportion of all innervated and denervated muscle fibres as well as the condition ofthe muscle after denervation.

Matched MeSH terms: Peripheral Nerve Injuries*
How Safe Is High-Speed Burring in Spine Surgery? An In Vitro Study on the Effect of Rotational Speed and Heat Generation in the Bovine Spine

Singh TS, Yusoff AH, Chian YK

Spine (Phila Pa 1976), 2015 Aug 1;40(15):E866-72.
PMID: 25996539 DOI: 10.1097/BRS.0000000000000985

In vitro animal cadaveric study.

Matched MeSH terms: Peripheral Nerve Injuries/etiology; Peripheral Nerve Injuries/prevention & control
Olfactory ensheathing cells seeded muscle-stuffed vein as nerve conduit for peripheral nerve repair: a nerve conduction study

Lokanathan Y, Ng MH, Hasan S, Ali A, Mahmod M, Htwe O, et al.

J Biosci Bioeng, 2014 Aug;118(2):231-4.
PMID: 24598302 DOI: 10.1016/j.jbiosc.2014.02.002

We evaluated bridging of 15 mm nerve gap in rat sciatic nerve injury model with muscle-stuffed vein seeded with olfactory ensheathing cells as a substitute for nerve autograft. Neurophysiological recovery, as assessed by electrophysiological analysis was faster in the constructed biological nerve conduit compared to that of autograft.

Matched MeSH terms: Peripheral Nerve Injuries/therapy
Neuroregenerative potential of lion's mane mushroom, Hericium erinaceus (Bull.: Fr.) Pers. (higher Basidiomycetes), in the treatment of peripheral nerve injury (review)

Wong KH, Naidu M, David RP, Bakar R, Sabaratnam V

Int J Med Mushrooms, 2012;14(5):427-46.
PMID: 23510212

We present a model case study of the activity of aqueous extract of Hericium erinaceus fresh fruit bodies in promoting functional recovery following crush injury to the peroneal nerve in adult female Sprague-Dawley rats. The aim was to explore the possible use of this mushroom in nerve repair. The activities of aqueous extract were compared to activities exhibited by mecobalamin (vitamin B12), which has been widely used in the treatment of peripheral nerve disorders. Analysis of walking track indicated that return of hind limb function and normal toe spreading occurred earlier in treated groups than in the negative control (non-treated) group. Regeneration of axons and reinnervation of motor endplates/neuromuscular junction in extensor digitorum longus muscle of rats in treated groups developed better than in the negative control group. Further, immunofluorescence studies also showed that dorsal root ganglia neurons ipsilateral to the crush injury in rats of treated groups expressed higher immunoreactivities for Akt and MAPK signaling pathways as well as c-Jun and c-Fos genes compared to the negative control group. Akt cascade plays a major role in mediating neurotrophin-promoted cell survival, while MAPK cascade is involved in mediating neurite outgrowth. Immediate early gene expression was also involved in the cascade of events leading to regeneration. Local axonal protein synthetic machinery was also enhanced in the distal segments of crushed nerves in treated groups. Therefore, daily oral administration of H. erinaceus could promote the regeneration of injured rat peroneal nerve in the early stage of recovery.

Matched MeSH terms: Peripheral Nerve Injuries/therapy*
Fulltext Supracondylar fractures of the humerus in children

Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:1.
PMID: 11200034
Matched MeSH terms: Peripheral Nerve Injuries*
Fulltext Therapeutic Potential of Complementary and Alternative Medicines in Peripheral Nerve Regeneration: A Systematic Review

Yow YY, Goh TK, Nyiew KY, Lim LW, Phang SM, Lim SH, et al.

Cells, 2021 08 25;10(9).
PMID: 34571842 DOI: 10.3390/cells10092194

Despite the progressive advances, current standards of treatments for peripheral nerve injury do not guarantee complete recovery. Thus, alternative therapeutic interventions should be considered. Complementary and alternative medicines (CAMs) are widely explored for their therapeutic value, but their potential use in peripheral nerve regeneration is underappreciated. The present systematic review, designed according to guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, aims to present and discuss the current literature on the neuroregenerative potential of CAMs, focusing on plants or herbs, mushrooms, decoctions, and their respective natural products. The available literature on CAMs associated with peripheral nerve regeneration published up to 2020 were retrieved from PubMed, Scopus, and Web of Science. According to current literature, the neuroregenerative potential of Achyranthes bidentata, Astragalus membranaceus, Curcuma longa, Panax ginseng, and Hericium erinaceus are the most widely studied. Various CAMs enhanced proliferation and migration of Schwann cells in vitro, primarily through activation of MAPK pathway and FGF-2 signaling, respectively. Animal studies demonstrated the ability of CAMs to promote peripheral nerve regeneration and functional recovery, which are partially associated with modulations of neurotrophic factors, pro-inflammatory cytokines, and anti-apoptotic signaling. This systematic review provides evidence for the potential use of CAMs in the management of peripheral nerve injury.

Matched MeSH terms: Peripheral Nerve Injuries/drug therapy*
Nerve injuries in supracondylar fractures of the humerus in children: is nerve exploration indicated?

Khademolhosseini M, Abd Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 Mar;22(2):123-6.
PMID: 23222035 DOI: 10.1097/BPB.0b013e32835b2e14

A retrospective study of nerve injuries with displaced supracondylar fractures of the humerus in children younger than 12 years of age, treated in Hospital Universiti Kebangsaan Malaysia. Our objectives were to determine the incidence of primary and iatrogenic nerve injuries in supracondylar humerus fractures Gartland types II and III and to determine the outcome of nerve recovery. A total of 272 patients with displaced supracondylar humerus fractures who required admission to Hospital Universiti Kebangsaan Malaysia from January 2000 to December 2007 were reviewed. There were 182 boys (67%) and 90 girls (33%). The mean age was 6.0 years, ranging from 1 to 12 years. Of 272 supracondylar fractures, 79 were type II and 193 were type III. Fifty-one (19%) patients had closed reduction, 160 (59%) had closed reduction and percutaneous crossed Kirschner (K) wires, and 61 (22%) had open reduction and crossed K-wires. Associated nerve injuries involving the median, radial, and ulnar nerves were observed in 48 (18%) patients. Nerve injuries were observed in nine (3%) patients upon admission. Thirty-nine (14%) patients developed nerve injuries following treatment. Of these 39 patients, 34 had ulnar, three had radial, and two had median nerve injuries. Nerve exploration was performed in five patients (in four patients following debridement of open fracture and in one because of unacceptable postoperative radiographs, and they subsequently underwent open reduction and exploration). Except for these five patients, the K-wires were not removed earlier nor were the nerves surgically explored in others. The nerve injuries resolved clinically on an average time of 3.5 months (range from 3 weeks to 8 months). Our study found complete resolution of all patients with nerve injuries confirmed by clinical assessment. On the basis of our study, we believe that there is no indication to remove the K-wires immediately or to explore the nerve surgically following a mini-open technique, which reduces the risk of penetrating a nerve during pinning.

Matched MeSH terms: Peripheral Nerve Injuries/etiology*; Peripheral Nerve Injuries/epidemiology; Peripheral Nerve Injuries/physiopathology
Fulltext Early Vessels Exploration of Pink Pulseless Hand in Gartland III Supracondylar Fracture Humerus in Children: Facts and Controversies

Tunku-Naziha TZ, Wan-Yuhana W, Hadizie D, Muhammad-Paiman, Abdul-Nawfar S, Wan-Azman WS, et al.

Malays Orthop J, 2017 Mar;11(1):12-17.
PMID: 28435568 MyJurnal DOI: 10.5704/MOJ.1703.005

The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve. Only one patient had persistent arterial constriction which required reverse saphenous graft. The brachial arteries were found to be compressed by fracture fragments, but were in continuity. The vessels were patent after the release of obstruction and the stabilization of the fracture. There was no transection of major nerves. The radial pulse was persistently present after 12 weeks, and the nerve activity returned to full function.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Supracondylar fractures of the humerus in children--an epidemiological study of 132 consecutive cases

Chai KK, Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:39-43.
PMID: 11200043

132 consecutive cases of supracondylar fractures of the humerus admitted between July, 1997 and February, 1999 were included in a prospective study. There were 93 boys and 39 girls. The age ranges from one to 14 years old. The non-dominant arm was more often injured. Ethnic Malay constituted the majority. Accidents mainly occurred at home with a peak between 4 pm and 8 pm. Majority was presented within 24 hours of injury. Type III fracture with distal fragment in extension predominated. Nerve injuries occurred in 9 cases in which median nerve was the most commonly affected. There was only one open fracture and it was complicated by absent radial pulse and median nerve injury.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Effectiveness of flaxseed oil on peripheral nerve regeneration following crush injury of sciatic nerve in rat: behavioural analysis and an electron microscopic study

Muhammad Danial Che Ramli, Nur Amira Sumari, Neni Widiasmoro Selamat, Hussin Muhammad, Junedah Sanusi

Malaysian Journal of Medicine and Health Sciences, 2020;16(101):106-111.
MyJurnal

Introduction: Peripheral nerve injuries (PNI) are a disabling injury as it often results in motor and sensory deficit with cognitive impairment. Flaxseed oil provides a good source of omega-3 fatty acid and it is believed to be able to protect the damaged nerve cell for successful nerve recovery. This study aimed to investigate a potential neuro-re- generation properties of flaxseed oil in treating the PNI. Methods: A total of 65 rats were separated into 4 groups: Group 1: Normal group (n=5), Group 2: Negative group (n=20), Group 3: Experimental group (n=20) and Group 4: Positive control (n=20), all the group were further divided into 4 groups (post-operative 7, 14, 21, 28 days, n=5 for each days). The functional restoration was assessed by walking track analysis (Sciatic Functional Index analysis-SFI) and toe spreading reflex (grading score). Electron microscope studies were performed on sciatic nerve to evaluate the regenerative process through morphologic and morphometric changes. Results: Oral administration of flaxseed oil (experimental group) at 1000 mg/kg body weight/day showed better recovery compared to negative control value. However, there was no significant difference in SFI and toe spreading reflex between positive (mecobalamin) and experimental group (flaxseed oil). Morphological and morphometrical findings indicated increases in the myelin thickness and myelin sheath layer after administration of flaxseed oil. Conclusion: The flaxseed oil supplementation could enhance the neurorestorative capacities of injured sciatic nerve.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Effect of tocotrienol rich fraction (TRF) on muscles reinnervation after sciatic nerve crush injury in rats

Amalia Lailanor, Nurul Alaina Hj Yahya, Junedah Sanusi, Huzwah Khaza’ai, Muhammad Danial Che Ramli

Malaysian Journal of Medicine and Health Sciences, 2020;16(101):118-124.
MyJurnal

Introduction: Muscle denervation is a process where muscles lose nerve supply due to neural damage and this may lead to paralysis in human. Muscle denervation is mainly caused by peripheral nerve injuries especially in the lower extremities that resulted in devastating effect on human daily functions and routines. Tocotrienol Rich Fraction (TRF) consist of 75% of tocotrienols have shown potential neuroprotective properties. The objective of this study is to ob- serve motor coordination and histological characteristics on muscles that underwent sciatic nerve crush injury and supplemented with TRF. Methods: A total of 104 Sprague-Dawley rats were divided into four groups; normal group (n=8) with no sciatic nerve crush injury, negative control (n=32) with sciatic nerve crush injury at hindlimb without treatment, positive control (n=32) sciatic nerve crush injury treated with 500 µg/kg/day of methylcobalamin, and experimental group (n=32) of rats that underwent sciatic nerve crush injury and treated with 200 mg/kg/day of TRF. Result: Skeletal muscles which located at hind limb; Soleus Muscle and Extenstor Digitorum Longus Muscle (EDL) muscle have shown an increasing in weight when it is supplemented with TRF 200 mg/kg/day and improved myelin layer of nerve. Conclusion: This study showed that TRF has the potency to improve reinnervation rate and neuron supply in hind muscle.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Centella asiatica (L.)-Neurodifferentiated Mesenchymal Stem Cells Promote the Regeneration of Peripheral Nerve

Hussin HM, Lawi MM, Haflah NHM, Kassim AYM, Idrus RBH, Lokanathan Y

Tissue Eng Regen Med, 2020 04;17(2):237-251.
PMID: 32036567 DOI: 10.1007/s13770-019-00235-6

BACKGROUND: Centella asiatica (L.) is a plant with neuroprotective and neuroregenerative properties; however, its effects on the neurodifferentiation of mesenchymal stem cells (MSCs) and on peripheral nerve injury are poorly explored. This study aimed to investigate the effects of C. asiatica (L.)-neurodifferentiated MSCs on the regeneration of peripheral nerve in a critical-size defect animal model.
METHODS: Nerve conduit was developed using decellularised artery seeded with C. asiatica-neurodifferentiated MSCs (ndMSCs). A 1.5 cm sciatic nerve injury in Sprague-Dawley rat was bridged with reversed autograft (RA) (n = 3, the gold standard treatment), MSC-seeded conduit (MC) (n = 4) or ndMSC-seeded conduit (NC) (n = 4). Pinch test and nerve conduction study were performed every 2 weeks for a total of 12 weeks. At the 12th week, the conduits were examined by histology and transmission electron microscopy.
RESULTS: NC implantation improved the rats' sensory sensitivity in a similar manner to RA. At the 12th week, nerve conduction velocity was the highest in NC compared with that of RA and MC. Axonal regeneration was enhanced in NC and RA as shown by the expression of myelin basic protein (MBP). The average number of myelinated axons was significantly higher in NC than in MC but significantly lower than in RA. The myelin sheath thickness was higher in NC than in MC but lower than in RA.
CONCLUSION: NC showed promising effects on nerve regeneration and functional restoration similar to those of RA. These findings revealed the neuroregenerative properties of C. asiatica and its potential as an alternative strategy for the treatment of critical size nerve defect.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Melatonin promotes Schwann cell dedifferentiation and proliferation through the Ras/Raf/ERK and MAPK pathways, and glial cell-derived neurotrophic factor expression

Tiong YL, Ng KY, Koh RY, Ponnudurai G, Chye SM

Exp Ther Med, 2020 Nov;20(5):16.
PMID: 32934681 DOI: 10.3892/etm.2020.9143

Upon peripheral nerve injury (PNI), continuous proliferation of Schwann cells is critical for axon regeneration and tubular reconstruction for nerve regeneration. Melatonin is a hormone that is able to induce proliferation in various cell types. In the present study, the effects of melatonin on promoting Schwann cell proliferation and the molecular mechanism involved were investigated. The present results showed that melatonin enhanced the melatonin receptors (MT1 and MT2) expression in Schwann cells. Melatonin induced Schwann cell dedifferentiation into progenitor-like Schwann cells, as observed by immunofluorescence staining, which showed Sox2 marker expression. In addition, melatonin enhanced Schwann cell proliferation, mediated by the upregulation of glial cell-derived neurotropic factor (GNDF) and protein kinase C (PKC). Furthermore, the Ras/Raf/ERK and MAPK signaling pathways were also involved in Schwann cell dedifferentiation and proliferation. In conclusion, melatonin induced Schwann cell dedifferentiation and proliferation via the Ras/Raf/ERK, MAPK and GDNF/PKC pathways. The present results suggested that melatonin could be used to enhance the recovery of PNI.

Matched MeSH terms: Peripheral Nerve Injuries
Fulltext Peripheral Nerve Regeneration Following Crush Injury to Rat Peroneal Nerve by Aqueous Extract of Medicinal Mushroom Hericium erinaceus (Bull.: Fr) Pers. (Aphyllophoromycetideae)

Wong KH, Naidu M, David P, Abdulla MA, Abdullah N, Kuppusamy UR, et al.

Evid Based Complement Alternat Med, 2011;2011:580752.
PMID: 21941586 DOI: 10.1093/ecam/neq062

Nerve crush injury is a well-established axonotmetic model in experimental regeneration studies to investigate the impact of various pharmacological treatments. Hericium erinaceus is a temperate mushroom but is now being cultivated in tropical Malaysia. In this study, we investigated the activity of aqueous extract of H. erinaceus fresh fruiting bodies in promoting functional recovery following an axonotmetic peroneal nerve injury in adult female Sprague-Dawley rats by daily oral administration. The aim was to investigate the possible use of this mushroom in the treatment of injured nerve. Functional recovery was assessed in behavioral experiment by walking track analysis. Peroneal functional index (PFI) was determined before surgery and after surgery as rats showed signs of recovery. Histological examinations were performed on peroneal nerve by immunofluorescence staining and neuromuscular junction by combined silver-cholinesterase stain. Analysis of PFI indicated that return of hind limb function occurred earlier in rats of aqueous extract or mecobalamin (positive control) group compared to negative control group. Regeneration of axons and reinnervation of motor endplates in extensor digitorum longus muscle in rats of aqueous extract or mecobalamin group developed better than in negative control group. These data suggest that daily oral administration of aqueous extract of H. erinaceus fresh fruiting bodies could promote the regeneration of injured rat peroneal nerve in the early stage of recovery.

Matched MeSH terms: Peripheral Nerve Injuries

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