title: The pattern of peripheral nerve injuries among Pakistani soldiers in the war against terror.
abstract: OBJECTIVE
  To determine the pattern of peripheral nerve injuries in Pakistani soldiers in the War against terror.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Department of Electrodiagnosis at Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi, Pakistan, from June 2008 to June 2011.
  
  
  METHODS
  All new cases of war wounded soldiers with peripheral nerve injuries were consecutively enrolled. Physical examination and electrodiagnostic study was carried out by experienced physiatrists. Data was entered in pretested especially designed questionnaire which was analysed using SPSS version 17.0. Seddon's classification system was used to assess the severity of injury.
  
  
  RESULTS
  There were 418 cases of peripheral nerve injuries with 504 different nerve segments. Mean age was 29.41 ±8 years. Blast was the main cause of nerve injury in 244 (48.5%) cases followed by gunshot in 215 (42.7%) and 45 (8.9%) cases had nerve injuries secondary to fall, burial under debris and motor vehicle accidents. Eighty six (17%) cases had multiple nerve injuries. Most commonly injured nerve was ulnar (20.6%) followed by sciatic (16.7%), median (16.5%), radial (16.3%), peroneal (8.7%), brachial plexus (8.5%), axillary (4.8%), tibial (2%), femoral (1.8%), long thoracic (0.4%) and others (3.8%). Axonotmesis was seen in 459 (91.1%) cases, 44 (8.7%) cases revealed neurotmesis and 1 (0.2%) case had neuropraxia.
  
  
  CONCLUSIONS
  Peripheral nerve injuries are a major component of war related injuries mainly involving the upper limbs. Electrodiagnostic studies help in assessing severity and determining prognosis. Precise documentation of severity of nerve injuries is important to estimate the burden on our resources and to extend rehabilitation services.
authors.affiliation: Department of Rehabilitation Medicine, Combined Military Hospital, Pano Aqil.
authors.forename: Sarah
authors.initials: S
authors.lastname: Razaq
authors.affiliation: Department of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi.
authors.forename: Rehana
authors.initials: R
authors.lastname: Yasmeen
authors.affiliation: Department of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi.
authors.forename: Aamir Waheed
authors.initials: AW
authors.lastname: Butt
authors.affiliation: Department of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi.
authors.forename: Noreen
authors.initials: N
authors.lastname: Akhtar
authors.affiliation: Department of Rehabilitation Medicine, Combined Military Hospital, Kohat.
authors.forename: Sahibzada Nasir
authors.initials: SN
authors.lastname: Mansoor
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003430:Cross-Sectional Studies; D005107:Explosions; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D010154:Pakistan; D059348:Peripheral Nerve Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D023481:Terrorism; D015599:Trauma Severity Indices; D014857:Warfare