Trauma- and treatment-associated peripheral nerve injuries following occupational accidents: a retrospective study

Peripheral nerve injuries after occupational accidents can result in significant functional and socioeconomic consequences.

This study aims to describe the characteristics and patterns of trauma- and treatment-related peripheral nerve injuries resulting from occupational accidents.

We retrospectively analysed 276 cases of traumatic peripheral nerve injury following occupational accidents, treated between 2018 and 2024 at a German university hospital. Injuries were classified by severity and anatomical location. Associations between injury characteristics, occupational sectors, treatment modalities and work incapacity were examined.

Most cases occurred in construction, trade/transport, metal industry and agriculture/forestry (63%). The leading causes were falls, crush, penetrating/cutting and impact injuries. In 24%, the nerve injury was treatment-related rather than caused by the initial trauma. The median, ulnar and peroneal nerves were most commonly affected. Severe deficits were present in 44% of patients at baseline; 26% remained severely affected at follow-up. Nerve surgery was performed in 38% of severe cases. Longer work incapacity was associated with fracture-related injuries (median = 210 days, Q1 = 133-Q3 = 375; Q1 = 25th, Q3 = 75th percentile), lower extremity involvement (240, 148-403 versus 180, 89-285; P < 0.001) and age >50 years (210, 140-409 versus 81, 29-143; P < 0.001).

Peripheral nerve injuries from occupational accidents are linked to substantial work incapacity. Key predictors of prolonged recovery include fractures, lower extremity involvement and older age. Treatment-related nerve damage accounts for a considerable share. Many patients show persistent deficits despite comprehensive care.