Primary epineural repair of the median nerve in children
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D A Hudson1, D G Bolitho, K Hodgetts
1Hand Unit, Red Cross Children's Hospital, Cape Town, South Africa.
Insights
Primary epineurial repair effectively treats pediatric median nerve lacerations, restoring motor and sensory function. Children achieved full functional recovery, indicating a positive prognosis for hand function after this surgical approach.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Hand Surgery
Background:
- Median nerve injuries in children can result from lacerations.
- Optimal surgical management for pediatric median nerve injuries is crucial for functional recovery.
- Primary epineurial repair is a common surgical technique for nerve repair.
Purpose of the Study:
- To evaluate the functional outcomes of primary epineurial repair in children with median nerve lacerations.
- To assess motor and sensory recovery following surgical repair.
- To determine the long-term functional prognosis for pediatric patients with median nerve injuries.
Main Methods:
- Retrospective case series of 18 children with median nerve lacerations.
- Surgical treatment involved primary epineurial repair.
- Patients were assessed at least 1 year post-injury for motor power (MRC scale), sensory recovery (2-point discrimination), and overall function (Bruininks-Oseretsky test).
Main Results:
- Mean motor power return to the opponens pollicis was 4.5 (MRC scale).
- Mean static 2-point discrimination improved to 5 mm.
- All children demonstrated full functional recovery based on the Bruininks-Oseretsky test.
Conclusions:
- Primary epineurial repair in children with median nerve lacerations yields highly satisfactory motor and sensory outcomes.
- A fully functional hand can be expected following this surgical intervention.
- This study supports primary epineurial repair as an effective treatment for pediatric median nerve injuries.
Abstract:
We report 18 children (12 boys and six girls) with a mean age of 6.1 years who sustained lacerations of the median nerve. Associated injuries to other structures occurred in 15 children. Treatment was by primary epineural repair. All the children were assessed at least 1 year after injury. The mean return of motor power to the opponens pollicis was 4.5 with a range of 3 to 5 (MRC scale) and the mean static 2-point discrimination was 5 mm (range 2-10 mm). All children showed a full functional recovery as assessed by the Bruininks-Oseretsky test. Primary epineurial repair in children leads to very satisfactory motor and sensory results. A fully functional hand can be expected.