Perspectives of treatment of post-traumatic neuropathies

Background. Treatment and diagnosis of peripheral neuropathy is a complex multidisciplinary problem that requires an effective solution. The search for rational modern treatment methods is an essential task today. Objective: based on the analysis of literature data, to systematize information on the main principles of diagnosis and treatment of peripheral post-traumatic neuropathy. Materials and methods. A systematic review of the literature is based on the analysis of sources from PubMed, Scopus, Web of Science, Google Scholar, etc. The search was conducted using the following keywords: neuropathy, nerve blocks, surgical treatment, conservative treatment. Results. Traumatization is one of the main causes of peripheral nerve damage. This problem becomes especially acute during combat operations, as the number of peripheral nerve injuries increases significantly. Post-traumatic neuropathy is a pathological condition caused by non-inflammatory nerve damage. It is often accompanied by chronic neuropathic pain, which leads to a significant decrease in limb function, in the patient’s quality of life and probable disability. Treatment of peripheral post-traumatic neuropathy requires a comprehensive and personalized approach. Particular attention should be paid to asses­sing the state of the neuromuscular apparatus when monitoring patients with post-traumatic neuropathy. Electromyography plays a key role in this issue. Standard measurable factors in the examination of patients with nerve damage are nerve conduction velocity and motor-sensory response to this impulse. Treatment of post-traumatic neuropathies can be conservative or surgical. The main directions of surgical treatment are endoneurolysis, neurorrhaphy and nerve transplantation. Conservative treatment of peripheral nerve injury includes pathogenetic therapy aimed at interfering with the process of natural regeneration of nervous tissue, increasing the efficiency of the reparative capacity of peripheral nerves and reducing subjective signs of chronic pain. Methods of comprehensive treatment of post-traumatic neuropathies include regional nerve blocks. The blockade has a significant analgesic effect, blocks the generation of nerve impulses, relieving the patient of pain and improving the overall effect of therapy. Conclusions. Treatment of peripheral post-traumatic neuropathy requires a comprehensive and personalized approach. Data on the most rational and optimal approach to the treatment of the above pathology and neuropathic pain in modern literature are somewhat contradictory, therefore they require more detailed study and systematization.