METHOD FOR INTRAOPERATIVE SELECTION OF SURGICAL MANAGEMENT OF PERIPHERAL NERVE INJURIES IN GUNSHOT INJURY Russian patent published in 2025 - IPC A61B8/00 A61B8/08 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to traumatology, neurosurgery and ultrasonic (functional) diagnostics, and can be used in treatment of gunshot injuries of extremities accompanied by damage of peripheral nerves. Intraoperative ultrasonic examination of the injured peripheral nerve is performed by placing an ultrasound transducer directly on the exposed peripheral nerve and performing its longitudinal and transverse scanning. In transverse scanning, a cross-sectional area of a nerve is measured in the area of damage, and an area of an intrastem neuroma is determined on an intact proximal portion. Lengthwise scanning is used to determine the length of the neuroma. Lidocaine test is performed, for which a lidocaine solution is injected subepineurally into a neuroma; a positive result of the test is considered to be a spread of lidocaine to the distal portions of the nerve, and a negative result is the absence of such spread to the distal portions. Combination of the obtained data is used to make a decision on endoneurolysis with dissection of the epineural membrane and subepineural adhesions, or neuroraphy, or neurotransplantation.

EFFECT: method enables intraoperative selection of the optimal surgical approach to the peripheral nerve injured due to gunshot injury.

1 cl, 1 tbl