Improving outcomes in traumatic peripheral nerve injuries to the upper extremity

Area of Science:

• Orthopedics
• Neurosurgery
• Regenerative Medicine

Background:

• Peripheral nerve lesions of the upper extremity are prevalent, causing significant patient disability.
• Accurate diagnosis via electroneurography, neurosonography, or MR neurography is crucial for effective treatment planning.

Purpose of the Study:

• To provide a comprehensive overview of current and emerging therapeutic methods for peripheral nerve lesions.
• To highlight strategies for nerve gap bridging, secondary reconstruction, and neuroma prevention.

Main Methods:

• Review of diagnostic modalities including electroneurography, neurosonography, and MR neurography.
• Discussion of reconstructive techniques such as autologous nerve grafts, bioartificial nerve conduits, and acellular nerve allografts.
• Exploration of tendon transfers, nerve transfers, and free functional muscle transfers for complex cases and amputations.

Main Results:

• Various surgical options exist for primary nerve repair and secondary reconstruction when direct repair is not feasible.
• Advanced techniques like target muscle reinnervation and regenerative peripheral nerve interfaces are vital for neuroma prevention in amputations.

Conclusions:

• A range of therapeutic approaches, from nerve grafts to muscle transfers, can address peripheral nerve lesions.
• Innovative strategies are continually being developed to improve outcomes for patients with upper extremity nerve injuries.