Modern approaches to medical rehabilitation of children with upper extremity peripheral nerve injury

摘要

The proportion of injuries to upper extremities, accompanied by nerve damage, ranges from 1.5% to 10%. Damage to the peripheral nerves of the upper extremity in children is associated with fractures of the long bones in 10–12% of cases. The high incidence of damage to the upper extremity peripheral nerves and the risk of impairment or loss of function and disability of the patient often require not only active conservative treatment, but also surgical intervention. The purpose of the work is the analysis of literature data and generalization of the results of our own research to determine the optimal technologies for medical rehabilitation of children with post-traumatic neuropathies of the upper extremities. The success of both conservative and surgical treatment of nerve injuries is largely determined by the volume and quality of the diagnostics performed. The goal of surgical or conservative treatment of peripheral nerve damage is to restore the nerve trunks conduction with the highest possible functional result. Physical factors occupy one of the leading places in the system of medical rehabilitation of children with post-traumatic neuropathies. The medical rehabilitation program includes the use of instrumental physiotherapy, robotic mechanotherapy, applied kinesitherapy, massage, soft manual techniques, orthosis, and kinesio taping. The leading technologies are the methods of motor rehabilitation. The kinesitherapy effects are potentiated by neuromodulatory methods of instrumental physiotherapy (magnetostimulation, electrical stimulation). Conclusion. In most cases, peripheral nerve injuries of the upper extremity in children require long-term staged medical rehabilitation. Meanwhile, to date, there are no clear recommendations for rehabilitation of children with damage to peripheral nerves in the postoperative period, and there is no unified algorithm for rehabilitation measures. Motor rehabilitation technologies are key in medical rehabilitation programs for children with post-traumatic neuropathy. Timely start of rehabilitation measures and differentiated prescription of physical factors according to the period of injury ensure the preservation of the surgical treatment result and contribute to the early restoration of the injured limb function.