The incidence of peripheral nerve injury in trauma patients in Iran

BACKGROUND
In patients aged 1-34 years, injury is the leading cause of mortality, disability and health care costs. Two to 3% of Level I trauma patients have peripheral nerve injury (PNI).
METHODS
Data were collected from the Iran National Trauma Registry database, compiled according to the International Classification of Diseases, 9th revision (ICD9) codes, from August 1999 to February 2004. The information included demography, mechanism, levels and regions of PNI, associated injuries, Abbreviated Injury Scale, duration of hospital stay, and costs.
RESULTS
Of 16,753 patients, 219 (1.3%) had PNI; 182 (83.1%) were male. The mean age of the patients with PNI was lower than of those without nerve injury (28.6±14.45 vs. 33±21.08 years; p<0.001). The most common cause of PNI was direct laceration from a sharp object (61%) followed by road traffic crashes (22%). Penetrating trauma was more common than non-penetrating injuries (5.6% vs. 0.4%, p<0.001). The most frequent PNI location was from the elbow to the hand (10%). The ulnar nerve was the most commonly injured nerve. The most common area of ulnar nerve injury was at the forearm (15.3%).
CONCLUSION
Sharp laceration and road traffic crash have the highest rates of PNI, which are more common in young males. Open wounds from the elbow to the hand should raise suspicion of PNI in triage. Although injuries leading to PNI are rare, their outcomes and disabilities require further research.

Ýran’da travma hastalarýndaki periferik sinir hasarýnýn insidansý

AMAÇ
Bir-34 yaþýndaki hastalarda yaralanma önde gelen mortalite, sakatlýk ve saðlýk bakým gideri nedenidir. Birinci seviye travma hastalarýnýn %2’si ile %3’ü periferik sinir hasarýna (PSH) sahiptir.
GEREÇ VE YÖNTEM
Veriler Aðustos 1999’dan Þubat 2004’e kadar olan zaman aralýðý içinde ICD9-kodlarýna göre Ýran Ulusal Travma Kayýt veritabanýndan toplandý. Bilgiler demografi, PSH’ye iliþkin mekanizma, seviyeler ve bölgeler ile eþlik eden hasarlar, Kýsaltýlmýþ Hasar Skalasý, hastanede kalma süresi ve hastane giderlerini içerdi.
BULGULAR
16,753 hastanýn 219’u (%1,3) PSH’li ve 182’si (%83,1) erkek idi. PSH’li hastalarýn ortalama yaþý, sinir hasarý olmayan hastalarýnkine göre daha düþük bulundu (28.6±14.45 ve 33±21,08 yaþ; p<0,001). En yaygýn PSH nedeni, keskin cisimden kaynaklanan direkt laserasyondu (%61) bunu karayolu trafik kazalarý (%22) izledi. Penetran travma, penetran yaralanmalara göre daha yaygýndý (%5,6 ve %0,4, p<0,001). En sýk PSH, dirsek ile el bölgesinde görüldü. (%10). Ulnar sinir, en sýk olarak yaralanan sinirdi. Ulnar sinir yaralanmasýna iliþkin en yaygýn alan, ön kol oldu (%15,3).
SONUÇ
Keskin laserasyon ve trafik kazasý, genç yaþ erkeklerde daha sýk olan PSH’ye iliþkin en yüksek oranlara sahiptir. Dirsekten itibaren ele doðru olan açýk yaralar, triyajda PSH’ye iliþkin kuþkuyu artýrmalýdýr. PSH’ye yol açan yaralanmalar nadir olmakla birlikte, bunlarýn sonuçlarý ve sakatlýklarý daha ileri araþtýrma gerektirmektedir.