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Traumatic Peripheral Nerve Injury in Mice
Published on: March 25, 2022
Long-Term Outcomes following Pediatric Peripheral Nerve Injury Repair
Benjamin Langridge1, Michelle F Griffin1,2,3, M A Akhavani1
1Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom.
Insights
Pediatric peripheral nerve repair shows excellent outcomes, with 95.4% of patients achieving sensorimotor recovery. Early surgical exploration and repair, even within 48 hours, are recommended for optimal results in children with nerve injuries.
Area of Science:
- Pediatric Surgery
- Neurology
- Orthopedics
Background:
- Peripheral nerve injuries in children are rare and difficult to diagnose.
- Limited data exists on long-term outcomes after surgical repair in pediatric patients.
- This study analyzes long-term sensorimotor and functional outcomes of pediatric peripheral nerve repair.
Purpose of the Study:
- To evaluate the long-term sensorimotor and functional outcomes of pediatric peripheral nerve repair.
- To identify factors influencing recovery after surgical intervention.
- To provide evidence-based recommendations for the management of pediatric peripheral nerve injuries.
Main Methods:
- Retrospective analysis of 108 pediatric patients with peripheral nerve injuries requiring surgical repair.
- Data collected included procedure type, time to surgery, injury mechanism, and postoperative recovery.
- 87 patients were included in the final analysis.
Main Results:
- 83 out of 87 patients (95.4%) achieved partial or complete sensorimotor recovery.
- Minor complications occurred in 10.3% of patients and were managed conservatively.
- Injury mechanisms included lacerations and crush injuries; younger age correlated with better recovery.
Conclusions:
- Surgical repair combined with hand therapy yields excellent functional outcomes in pediatric peripheral nerve injuries.
- A low threshold for surgical exploration and repair is advised, especially with diagnostic uncertainty.
- Optimal sensorimotor recovery can be achieved with repair within 48 hours, though timing is patient-dependent.
Abstract:
Introduction Peripheral nerve injuries in children are uncommon and can be challenging to diagnose. There is a paucity of data on long-term sensorimotor and functional outcomes following surgical repair. We present a 12-year retrospective analysis of pediatric peripheral nerve repair with long-term functional outcomes. Materials and Methods We performed a retrospective analysis of pediatric patients with peripheral nerve injury requiring surgical repair. Clinical records were analyzed for procedure type, time to surgery, mechanism of injury, postoperative recovery, and complications. Results A total of 108 patients were identified and 87 patients were included. Out of 87 patients, 83 (95.4%) had partial or complete sensorimotor recovery at final follow-up and 4 did not improve. Minor complications occurred in 10.3% of patients, all resolved with conservative management. Mechanisms of injury were predominantly lacerations with sharp objects or crush injuries. Age at time of injury was inversely correlated with sensorimotor recovery, and time to surgical repair was not. Conclusion Surgical repair with long-term hand therapy results in excellent functional outcomes following pediatric peripheral nerve injury. A low threshold for exploration and repair should be used in instances of diagnostic uncertainty. Timing of surgical repair is dependent on a patient's clinical presentation; however, repair within 48 hours is sufficient for optimal sensorimotor recovery.
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