Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

Abstract

OBJECTIVE:To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries.DATA SOURCES:The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011.STUDY SELECTION:The following types of article were selected: (1) clinical trials describing the repair of median, ulnar, radial, and digital nerve injuries published in English; and (2) studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to investigate the patient and intervention factors associated with outcomes.MAIN OUTCOME MEASURES:Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3+ or S4.RESULTS:Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were independent predictors of outcome after the repair of nerve injuries (P < 0.05), and that the nerve injured was the main factor affecting the rate of good to excellent recovery.CONCLUSION:Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up.

Characterising cellular and molecular features of human peripheral nerve degeneration

“…Clinical reports have suggested that optimal functional recovery is dependent upon a sufficient number and quality of axons reaching their target within 1 year following injury [15][16][17][18]. After this time period, functional outcomes are poor [18][19][20]. This same pattern of strong initial regeneration potential followed by declining regenerative capacity during chronic denervation and poor functional outcomes from repair of proximal injuries suggests that the basic biology is likely to be comparable between rodents and humans.…”

Peroneal Nerve Repair of a 9 Year Old: Return of Motor Function after 2 Years

“… 6 Additionally, age plays a role in nerve plasticity and regaining function. Younger age has been associated with increased recovery due to children’s increased regenerative capabilities, with children having faster recovery times (mean of 18 months) compared with adults (average of 30–39 months) for peroneal nerve repairs.. 4 , 5 , 11 , 12 …”

Past, Present, and Future of Nerve Conduits in the Treatment of Peripheral Nerve Injury

“…Despite early diagnosis and accurate nerve repair with modern surgical techniques, functional recovery never reached the preinjury level. Poor outcomes result from factors both intrinsic and extrinsic to the nervous system, such as the type and level of injury, integrity of the surrounding tissues, the timing of the surgery, and changes in spinal cord neurons and end organs [ 5 – 7 ]. Misdirection of regenerating axons at the injury site is still a major problem.…”