SIMULTANEOUS LESIONS OF DIFFERENT NERVES
Injuries of more than one nerve of the upper limb are very frequently encountered. According to our investigations they constitute 11,7% of all injuries to the peripheral nerves.
Combined injury of several nerves of the upper limb is observed more often in the arm than in the forearm. The most frequent combination consists of injury of the median and the ulnar nerves. After that comes in order of frequency injury of the median and the radial, and more rarely there are simultaneous injuries of the three nerves of the upper limb. In simultaneous injury of the median and the ulnar nerves, the skin incisions in the surgical approaches are to expose both nerves by one incision. (Fig. 21-41). At the arm, combined approaches are easily achieved as the nerves run very close to one another. In the forearm it is most convenient to make curved incision between the projections of the two nerves. In some simultaneous nerve injuries of the upper limb, the surgical approaches must be planned as described above, independently of one another.
