| Abstract | Periferni ţivĉani sustav, kojeg ĉine svi ţivci izvan središnjeg, je odgovoran za prijenos ţivĉanih impulsa od mozga do mišića, organa, ţlijezda i ţila, te za prijenos impulsa u mozak iz osjetnih receptora raznih dijelova tijela te osjetnih organa. Oštećenje ţivca ovog sustava rezultira ispadom njegovog inervacijskog podruĉja. Najĉešće lezije perifernih ţivaca su : oštećenje nervusa facialisa, nervusa medianusa, nervusa peroneusa, nervusa ulnarisa te nervusa radialisa. Od posebne je vaţnosti n.radialis, ĉijom povredom najĉešće dolazi do stanja poznatim pod nazivom viseća šaka, koju karakterizira oteţana ili onemogućena ekstenzija šake i prstiju. Nervus radialis je mješoviti ţivac, što znaĉi da njegovom povredom nije oštećena samo funkcija šake, već i senzorika. MeĊutim, senzorni simptomi su minimalni te su ograniĉeni na malo podruĉje dorzuma šake. Do kompresije ţivca najĉešće dolazi na mjestu gdje on obilazi humerus, na sredini nadlaktice. Ĉesto do takve kompresije dolazi kod alkoholiĉara, koji se ujutro bude bez mogućnosti ekstenzije u šaci i prstima (paraliza subotnje veĉeri). RjeĊe mjesto kompresije se dogaĊa u visini supinatora, to je tzv. supinatorski sindrom, kod kojeg su, osim tipiĉnog motoriĉkog deficita, ĉeste i bolne senzacije koje iradiraju u prste. Dijagnoza ovog stanja je relativno lagana, postoji niz testova koji mogu ukazati na slabost motorike uobiĉajene za ovaj ţivac, a potvrĊuje se EMNG nalazom denervacije. Oporavak je izrazito dobar, fizikalna terapija ima bitnu ulogu u rehabilitaciji ove ozljede. Na primarnom mjestu se nalazi kinezioterapija, a dosta se obilno koriste i procedure elektrostimulacije te elektroterapije. Kinezioterapija obuhvaća pasivne, aktivno potpomognute te aktivne vjeţbe ( s otporom i bez). Kao uvodna procedura, za smanjivanje boli i povećanje mišićne kontrakcije korisna je primjena termoterapije. Osim fizioterapijskih procedura, za rehabilitaciju ozljeda n.radialisa je veoma vaţno pravilno pozicioniranje ekstremiteta te upotreba ortopedskih pomagala. |
| Abstract (english) | The peripheral nervous system, which consists of nerves outside of the central nervous system, is responsible for the transmission of nerve impulses from the brain to the muscles, organs, glands and vessels, and for the transmission of impulses to the brain from sensory receptors of various body parts and sensory organs. Damaging the nerves of this system results in a breakdown of its receptive field. The most common lesions of the peripheral nerves are of the facial nerve, median nerve, nerve peroneus, ulnar and radial nerve. Lesion of the radial nerve is of particular importance because it usually results in a state known as 'The wrist drop', which is characterized with difficult or impossible extension of hand and fingers. Radial nerve is a mixed nerve, which means that the breach does not only damage its function, but also sensors. However, sensory symptoms are minimal and are limited to a small area of the dorsum of the hand. The most common radial neuropathy occurs at the spiral groove,in the middle of the upper arm. This type of nerve entrapment usually occurs in alcoholics, who wake up in the morning with weakened extension of the hand and fingers ('Saturday night palsy'). Less frequent place of compression occurs around the supinator muscle, it's a condition called supinator syndrome. In addition to typical motor deficits, this syndrome is characterized with frequent and painful sensations radiating into fingers. The diagnosis is relatively easy, there are a number of tests that can indicate muscle weakness typical for this nerve injury, but diagnosis is confirmed with signs of EMG denervation. Recovery is extremely good, physical therapy plays an important role in the rehabilitation of these injuries. Most effective results derive from kinesiotherapy and from procedures of electrostimulation and electrotherapy. Kinesiotherapy includes passive, active assisted and active exercise (with resistance and without). Thermotherapy is often used as an initial procedure for reducing pain and increasing muscle contraction. In addition to procedures of physical therapy, proper positioning of the limbs and usage of orthopedic aids is crucial for a successful rehabilitation of the radial nerve. |
