Treatment of traumatic peripheral nerve injury

Peripheral nerve injuries are caused by traction, laceration and missile injury. Primary surgical repair is recommended for clean, sharp injuries that cause transection of a nerve. In compressed, stretched or contused nerves, surgical repair at three months is indicated if functional recovery has not occurred. Electromyography and nerve conduction studies are helpful in deciding which patients need secondary repair. Recovery is possible for 18 months following injury. Since nerve regeneration occurs at a rate of one inch per month, the distance from the nerve injury to the innervated muscle must be less than 18 inches. Therefore, the outcome is generally better in distal lesions than in proximal ones.