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Published on: October 6, 2020
Microsurgical management of penetrating peripheral nerve injuries: pre, intra- and postoperative analysis and results
S Rochkind1, G Filmar, Y Kluger
1Division of Peripheral Nerve Reconstruction, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. rochkind@zahav.net.il
Background And Methods:
Clinical and electrophysiological motor function data were compared before and after microsurgical repair of penetrating peripheral nerve injuries. Sixty-four patients totaling 74 injured nerves (25 gunshot wounds, 49 stab wounds) were treated with external and interfascicular neurolysis and/or interfascicular nerve grafts. Microsurgery was performed 2-12 months after the injury (Group 1, 33 patients,) and 12 months-60 years after the injury (Group 2, 31 patients). The postoperative clinical and electrophysiological follow-up period ranged between 1 and 5 years.
Results:
A statistically significant improvement in muscle strength occurred after the microsurgery, compared to before repair, gunshot wounds (p < 0.001), stab wounds (p < 0.001). Intraoperative and postoperative electrophysiological analysis showed statistically significant improvement. TIMING OF SURGERY: No statistically significant difference in muscle strength occurred between the 2 groups after the surgery, each showing statistically significant improvement, Group 1 (p < 0.001), Group 2 (p < 0.001). Patients above and below age of 40 showed an improvement in muscle strength after microsurgery, (p < 0.001) and (p < 0.001), respectively.
Conclusion:
Microsurgery can progressively improve nerve function in penetrating peripheral nerve injuries and lead to significant functional improvement, even when it is delayed for more than one year after the injury.
