Long term results of primary repair of combined cuts of median and ulnar nerves on forearm

Purpose: Lacerations to the ulnar and median nerve in the volar forearm have demonstrated considerable long-term clinical and socioeconomic impacts on patients. The purpose of this study was to evaluate the outcomes of complex volar forearm lacerations involving one or more major peripheral nerves in an economically disadvantaged patient population. Methods: In this study, a retrospective analysis of 61 patients who sustained lacerations to the median nerve, ulnar nerve, or both with volar wrist lacerations was performed. Each patient's preinjury and postinjury occupation, dominant extremity, and demographic variables were evaluated. Sensation recovery, motor recovery, Disabilities of the Arm, Shoulder, and Hand scores, visual analog scale scores, cold intolerance, and return to work were evaluated at 3, 6, and 12 months after the injury. Results: Patients with isolated median nerve injuries demonstrated improved motor recovery compared with patients with isolated ulnar nerve injuries. Patients with combined nerve injuries had worse sensation recovery and motor recovery, and lower rates of return to work than either group of patients with isolated nerve injuries. Manual laborers had worse motor recovery and lower rates of return to work than did patients who were office workers. Conclusions: Patients with combined median and ulnar nerve injuries have worse functional recovery and lower rates of return to work than do patients with isolated median or isolated ulnar nerve injuries at 1 year. Manual laborers demonstrated worse functional recovery and lower rates of return to work compared with office workers at 1 year.

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Outcomes and Return to Work Following Complex Nerve Lacerations in the Volar Forearm in an Underserved Spanish-Speaking Population

Bucknam

Dunn

Fernandez

et al. 2020

Journal of Hand Surgery Global Online

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MicroRNA-142a-3p regulates neurogenic skeletal muscle atrophy by targeting Mef2a

Gu¹,

Wang²,

Li³

et al. 2023

Molecular Therapy - Nucleic Acids

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Cold sensitivity and its association to functional disability following a major nerve trunk injury in the upper extremity—A national registry-based study

et al. 2022

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Aims To investigate self-reported cold sensitivity and functional disability after a repaired major nerve trunk injury in the upper extremity. Methods We identified 735 individuals with a major nerve trunk injury in the upper extremity, surgically treated with direct nerve repair or reconstructed with nerve autografts, in the Swedish national quality registry for hand surgery (HAKIR). Patient-reported symptoms, including cold sensitivity, and perceived disability were collected using two questionnaires (HQ-8 and QuickDASH) preoperatively, and at three and 12 months postoperatively. Results We included 281 individuals, who had responded the questionnaires, where 197 (70%) were men (median age 34 [interquartile range 25–52] years) and 84 (30%) were women (median age 41 [25–55]). Cold sensitivity (scored 0–100) was the most prominent symptom 12 months postoperatively after an injured and repaired/reconstructed median (p<0.001) or ulnar (p<0.001) nerve, while individuals with a radial nerve injury showed milder symptoms. Concomitant injuries did not affect cold sensitivity scores. Individuals with ulnar nerve injuries scored higher in stiffness (p = 0.019), weakness (p<0.001) and ability to perform daily activities (p = 0.003) at 12 months postoperatively than median nerve injuries. Individuals with a median, ulnar or radial nerve injury with severe (>70) cold sensitivity had 25, 37 and 30 points higher QuickDASH scores, respectively (p<0.001), at 12 months postoperatively than individuals with mild (<30) cold sensitivity. There were no differences in QuickDASH score or cold sensitivity score at 12 months postoperatively between direct nerve repair or nerve reconstruction with nerve autografts. Neither age, nor sex, affected QuickDASH score at 12 months postoperatively. Conclusion Cold sensitivity after surgery for a major nerve trunk injury in the upper extremity can be substantial with impaired ability to perform daily activities, where an ulnar nerve injury may have a worse outcome.

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Long term results of primary repair of combined cuts of median and ulnar nerves on forearm

Abstract: BACKGROUND: The objective of this clinical study was to evaluate sensory and motor functions in the later period following primary repair of combined injuries of the ulnar and median nerves in the forearm at proximal, middle, and distal levels.

Cited by 4 publications

References 15 publications

Outcomes and Return to Work Following Complex Nerve Lacerations in the Volar Forearm in an Underserved Spanish-Speaking Population

Outcomes and Return to Work Following Complex Nerve Lacerations in the Volar Forearm in an Underserved Spanish-Speaking Population

MicroRNA-142a-3p regulates neurogenic skeletal muscle atrophy by targeting Mef2a

Cold sensitivity and its association to functional disability following a major nerve trunk injury in the upper extremity—A national registry-based study

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