The Role of Ultrasonography in Detecting Additional Peripheral Nerve Injuries Overshadowed by Clinical and Electrodiagnostic Data in Patients With Peripheral Nerve Injury After the February 6, 2023 Earthquake

In the study, patients with peripheral nerve injuries who were removed from under the rubble during the earthquake were evaluated. Patients were examined clinically and monitored for possible peripheral nerve and plexus damage.

After obtaining the written and verbal consent of the patients, their identity information, height and weight, professions, the city where they were affected by the earthquake, the duration of their stay under the rubble, the surgical treatments applied until the moment of evaluation, and their medical interventions. The treatments they received (such as steroid use), comorbidities and medications they used were recorded. Patients who had not yet had an ENMG examination were evaluated electrophysiologically. ENMG was then performed by a physiatrist who specializes in peripheral nerve ultrasonography.

In addition to ENMG and sonographic examinations, each patient was evaluated with Quick-DASH (disabilities of the arm, shoulder and hand) and lower extremity functional scale (LEFS) questionnaires.

There are eleven questions in the Quick-DASH survey, each organized on a five-point Likert scale. In these questions, situations related to the functions of the hand, shoulder and upper extremity are questioned. The patient is asked to mark 1 point as "no difficulty", 2 points as "mild difficulty", 3 points as "moderate difficulty", 4 points as "extreme difficulty", and 5 points as "not being able to do it at all". The Quick-DASH score is obtained by subtracting one from the ratio of the total score of the marked items to the number of marked items and multiplying the resulting number by twenty-five. A Quick-DASH score between 0 and 20 indicates normal disability, between 21 and 40 indicates mild disability, between 41 and 60 indicates moderate disability, between 61 and 80 indicates severe disability, and >80 indicates very severe disability.

There are twenty questions in the LEFS survey, each organized on a five-point Likert scale. In these questions, the functionality of the lower extremity in daily life is questioned. The patient is asked to mark "extreme strain or inability" as 0 points, "considerable strain" as 1 point, "moderate strain" as 2 points, "some strain" as 3 points, and "no strain" as 4 points. The minimum score that can be obtained from the survey is zero, while the maximum score is eighty. As the score decreases, it means a decrease in functionality.