Case Series of Traumatic Peripheral Nerve Injuries in Pediatric Patients Treated with Allograft Repair

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Trauma Surgery

Background:

• Autologous nerve grafting is common for peripheral nerve injuries, but allografts are gaining traction in adults due to similar recovery and no donor site morbidity.
• Pediatric peripheral nerve injuries are less studied, with limited data on incidence and treatment outcomes.
• This study addresses the gap in knowledge regarding traumatic pediatric peripheral nerve injuries treated with allografts.

Purpose of the Study:

• To explore the epidemiology of traumatic pediatric peripheral nerve injuries.
• To evaluate the outcomes of nerve allograft reconstruction in children.
• To determine the viability of allograft reconstruction for pediatric nerve gaps.

Main Methods:

• Retrospective case series utilizing a prospectively maintained database.
• Inclusion of all pediatric patients undergoing nerve allograft reconstruction at a Level I trauma center (September 2011 - July 2021).
• Analysis of patient demographics, injury mechanisms, nerve involvement, gap length, repair timing, and functional recovery.

Main Results:

• 24 allograft reconstructions in 18 pediatric patients (average age 12.9 years).
• Common injuries included digital, ulnar, and median nerves, often caused by motor vehicle accidents or sharp injuries.
• At an average follow-up of 13.7 months, 38% achieved full sensory recovery, and 25% had protective sensation.

Conclusions:

• Nerve allograft reconstruction is a feasible treatment option for pediatric peripheral nerve injuries with gaps unsuitable for direct repair.
• The study demonstrates positive functional recovery, particularly sensory restoration, in pediatric patients treated with nerve allografts.
• Allograft reconstruction offers a valuable alternative to autografting in pediatric cases, mitigating donor site complications.