Nerve Conduction Study and Functional Assessment After Upper Extremity Macroreplantation

Objectives: The recovery of arm function after macroreplantation is influenced by various factors. The aim of this study was to present the results of functional rehabilitation outcome after replantation of an upper extremity. Moreover, we assessed nerve conduction validity in the process of monitoring the return of manual functions. Methods: The study was performed in a group of seven patients after upper extremity macroreplantation and rehabilitation. Assessments included measuring hand/arm function loss using Swanson's method, range of motion, muscle strength, sensation, and manipulation dexterity through the NHPT (Nine-Hole Peg Test). The nerve conduction study measured response amplitude, conduction speed, and distal latency. Results: The average loss of function of the hand diminished from 63.6% to 49.18%. Significant improvement in global pressure was achieved. In the functional capacity test (NHPT), the average time of the test was improved. The final nerve conduction study demonstrated improvements in motor and sensory conduction parameters. A correlation between improvement in conduction parameters in sensory fibers and sensation in the two-point discrimination test was found. Increased potential amplitude in motor fibers of the examined nerves correlated with a decrease in loss of function of the arm. Conclusions: Functional assessment and tailored rehabilitation strategies would maximize recovery potential after macroreplantation. Nerve conduction remains a crucial tool in monitoring the progress of manual skills after months of rehabilitation. Our findings highlight the importance of long-term follow-up of these patients.