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Upper limb nerve injuries in developmental age

Filippo M Senes1, Riccardo Campus, Flavio Becchetti

  • 1Orthopedics Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy. filipposenes@ospedale-gaslini.ge.it

Microsurgery
|May 5, 2009
PubMed

Insights

This study on pediatric peripheral nerve injuries found that median and radial nerve injuries have a good prognosis, while ulnar nerve injuries fare poorly. Surgical exploration is recommended at 6 months if conservative treatment fails.

Area of Science:

  • Pediatric surgery
  • Neurology
  • Traumatology

Background:

  • Peripheral nerve injuries in children's upper limbs are often trauma-related.
  • Understanding injury types, locations, and outcomes is crucial for effective treatment.

Purpose of the Study:

  • To validate a therapeutic approach for pediatric upper limb peripheral nerve injuries.
  • To determine optimal waiting times for surgical exploration of these injuries.

Main Methods:

  • A case series analysis of 105 children with peripheral nerve injuries.
  • Evaluation included lesion type, nerve injury site, motor/sensory outcomes, recovery time, and surgical results.
  • Treatment strategies involved immediate repair for open injuries and delayed surgery for closed injuries.

Main Results:

  • Open injuries (Sunderland V) were treated with direct suturing, grafts, or tubules.
  • Closed nerve injuries required a waiting period before surgical intervention.
  • Median and radial nerve injuries showed favorable outcomes, unlike ulnar nerve injuries.
  • Surgical intervention was suggested at 6 months post-injury if no clinical improvement was observed.

Conclusions:

  • Prompt surgical intervention is recommended for open injuries.
  • A 6-month waiting period is suggested for closed injuries before surgical exploration, especially if conservative measures fail.
  • Early skeletal fixation is vital for fractures with potential nerve involvement.

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