Rehabilitation of peripheral nerve injuries

Rehabilitation of the patient with a peripheral nerve injury requires knowledge, understanding, and cooperation between the patient, the physician, and the therapist. Careful documentation of the patient's status prior to beginning rehabilitation and periodic follow-up assessments are of utmost importance. We have presented a detailed scheme for initial and follow-up evaluation. Prevention of unnecessary stiffness, swelling, and contractures is emphasized. Education of the patient to prevent the individual from doing further damage to the anesthetic area is important. Proper splinting techniques, from the postoperative splint and cast to splints that prevent deformities as well as overcome established contractures and improve function, will aid in the patient's recovery. Desensitization is an important aspect of sensory recovery, and sensory reeducation will aid in recovery of sensibility. Early tendon transfers are found to be particularly advantageous for high radial and median nerve palsies to gain functional recovery earlier and to allow the patient to become brace-free sooner.