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Documentation of posttraumatic nerve compression in patients with normal electrodiagnostic studies
J Henk Coert1, Marcel F Meek, David Gibeault
1Department of Plastic Surgery, University Hospital Groningen, Groningen, The Netherlands.
The Journal of Trauma
|February 13, 2004
Summary
Pressure-Specified Sensory Device testing identifies nerve compression after trauma, even with normal electrodiagnostics. This aids workers' compensation approval and legal settlements for patients, including those with diabetic neuropathy.
Area of Science:
- Neurology
- Orthopedic Surgery
- Trauma Care
Background:
- Standard electrodiagnostic tests may miss posttraumatic nerve compression despite patient symptoms.
- Computer-assisted neurosensory testing is valuable for documenting peripheral nerve sensory impairment.
- Accurate documentation of nerve compression is crucial in trauma cases with legal implications, particularly for diabetic patients with neuropathy.
Purpose of the Study:
- To evaluate the utility of the Pressure-Specified Sensory Device (PSSD) in identifying peripheral nerve problems in trauma patients with initially normal electrodiagnostic studies.
- To determine if PSSD testing can facilitate surgical intervention and legal outcomes in these cases.
Main Methods:
- A prospective study followed trauma patients with normal electrodiagnostic results.
- Patients underwent testing with the Pressure-Specified Sensory Device (PSSD).
- Surgical care and legal outcomes were contingent on PSSD-documented abnormalities. Eight patients, including four with diabetes, were analyzed.
Main Results:
- Neurosensory testing using the PSSD successfully documented peripheral nerve problems in all eight patients.
- This objective documentation was critical for securing workers' compensation approval for nerve decompression surgery.
- PSSD findings facilitated the legal settlement process for the affected individuals.
Conclusions:
- Neurosensory testing with the PSSD is effective in identifying trauma-related peripheral nerve compression.
- This diagnostic tool aids in patient management and facilitates necessary interventions, even in the presence of complicating factors like diabetic neuropathy.