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[Results of nerve repair on the upper limbs]
Abstract:
This paper concerns the clinical results of microsurgical repair to nerve injuries on the upper extremities of 66 patients, who had sustained a total of 126 nerve injuries. The majority of these cases involved lesions of the sensory nerves, occurring in the area of the palmar surface of the hand and flexor surface of the fingers (102 nerves and 24 injuries involving the nerve trunks of the median and ulnar nerves). -- Fifty-five percent of the cases were treated primarily, 25% secondarily, and the remaining 20% required nerve transplants. Forty percent involved crush injuries and 87% had sustained associated injuries. -- Tests for tactile gnosis were performed by means of "blindfold" tests. The analysis of the results was carried out according to accepted methods; the "Sedon" method was adapted in order to be able to judge the sensibility from a more functional aspect. -- The repair to sensory nerves is more successful than that carried out on the motor nerves. The degree of success is dependent upon the age of the patient, the nature of the wounds, and the associated injuries. -- Results of primary nerve suture are considerably better than those resulting from nerve transplants even in cases of unfavorable soft issue conditions. Thus, our opinion is that an experienced hand surgeon trained in the field of microsurgery should not be afraid of undertaking primary repair procedures as long as the technical and administrative requirements are adequate.