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Published on: October 6, 2020
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Combat-Sustained Peripheral Nerve Injuries in the United States Military
John C Dunn1, Michael D Eckhoff1, Tyler C Nicholson1
1Department of Orthopaedics, William Beaumont Army Medical Center, El Paso, TX.
The Journal of Hand Surgery
|October 5, 2020
Summary
Combat-related nerve injuries in service members are common. Faster evaluation by a specialized team improved sensory recovery, highlighting the importance of multidisciplinary care for combat-sustained peripheral nerve injuries.
Area of Science:
- Neurology
- Traumatology
- Military Medicine
Background:
- Combat-sustained peripheral nerve injuries (CSPNIs) are increasing due to high-energy blast mechanisms.
- These injuries pose significant challenges in contemporary warfare.
Purpose of the Study:
- To describe CSPNIs and evaluate outcomes in a military setting.
- To test the hypothesis that prompt evaluation by a multidisciplinary team improves outcomes.
Main Methods:
- Analysis of a database of 104 service members treated by the Peripheral Nerve Consortium (PNC) between 2004-2009.
- Inclusion of injury characteristics, surgical procedures, and Medical Research Council outcomes.
- Correlation of injury severity and time to evaluation with final outcomes.
Main Results:
- 138 peripheral nerve injuries (PNIs) were identified in 104 service members.
- Associated injuries included fractures, multiple PNIs, vascular injury, and traumatic brain injury.
- Shorter time to evaluation correlated with better final sensory recovery (S1/S2 vs. S0), but not motor recovery.
Conclusions:
- More severe initial injuries predict worse final outcomes.
- Timely referral, though infrequent, is associated with improved sensory recovery.
- Multidisciplinary teams are crucial for managing complex CSPNIs.
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