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

Bucknam, Ryan B.; Dunn, John C.; Fernandez, Isaac; Nesti, Leon J.; Gonzalez, Gilberto

doi:10.1016/j.jhsg.2019.12.002

Cited by 4 publications

(9 citation statements)

References 33 publications

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“…30–34) are in agreement with the results of a previous study of individuals with similar injuries (i.e. 29–31) [ 40 ].…”

Section: Discussionsupporting

confidence: 91%

“…injuries. Furthermore, no difference in QuickDASH scores 12 months postoperatively between men and women with median (30 [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and 28 ; p = 0.580), ulnar (34 and 34 ; p = 0.716), or radial (17 and 14 ; p = 0.966) nerve injuries were found. Concomitant injuries were equally common among women and men regardless of injured nerve trunk.…”

Section: Plos Onementioning

confidence: 99%

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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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“…30–34) are in agreement with the results of a previous study of individuals with similar injuries (i.e. 29–31) [ 40 ].…”

Section: Discussionsupporting

confidence: 91%

Section: Plos Onementioning

confidence: 99%

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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“…This difference persisted even after adjusting for age, sex, immigration, sick leave, education, manual work, cohabitation, income, and diabetes status. These findings align with prior research, where QuickDASH scores for surgically treated digital nerve injuries were generally lower (mean score 7–9) 24 , 25 than those for individuals with a surgically treated major nerve trunk injury (mean score 29–31) 26 . Digital nerve injuries primarily affect finger sensation and fine motor skills, whereas major nerve trunk injuries impact both arm and hand motor function and sensation 27 , 28 , and both types of nerve injuries have a risk of residual pain problems, despite surgery.…”

Section: Discussionsupporting

confidence: 88%

“…Educational disparities can lead to more significant bodily pain, partly attributed to health literacy 35 . Previous research on manual laborers also reported worse motor recovery and lower return-to-work rates compared to office workers, with a median QuickDASH score at 12 months of 34 vs. 27, respectively 26 . Psychosocial factors, including depression, coping strategies, and anxiety, can influence outcome, like pain level, patient satisfaction, and disability 36 .…”

Section: Discussionmentioning

confidence: 85%

Socioeconomic factors and outcome after repair and reconstruction of digital and major nerve trunk injuries in the upper limb

Frostadottir,

Perez,

Dahlin

2024

Sci Rep

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Peripheral nerve injuries in the upper limb can lead to substantial disability and pain. We aimed to assess how socioeconomic factors affect outcomes after repaired or reconstructed digital or major nerve trunk injuries in the upper limb. We identified 670 individuals, who underwent surgical nerve repair or reconstruction using sensory nerve autografts, in the Swedish National Quality Registry for Hand Surgery 2010–2018. Socioeconomic factors, including education, cohabitation, type of work, sick leave, immigrant status and income, were gathered from the Swedish statistical agency (www.scb.se) and National Diabetes Register (NDR). We calculated prevalence ratios (PR) to assess the relationship between socioeconomic factors and surgical outcomes for the nerve injuries. Individuals with a major nerve trunk injury had higher QuickDASH scores and lower income compared to those with digital nerve injury. Individuals with immigration background (adjusted PR = 2.0, 95% CI 1.2–3.2), history of > 4 weeks of sick leave the year before surgery (adjusted PR = 1.8, 95% CI 1.1–3.1), or education level below tertiary (adjusted PR = 2.8, 95% CI 1.7–4.7) had significantly higher QuickDASH scores. Recognizing impact of non-biological factors, including immigration, prior sick leave, and education level, on outcome after nerve surgery is crucial for improving prognosis in socioeconomically deprived individuals.

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“…[ 2 ] Complex hand injuries may cause lifelong impairment associated with social and economic difficulties. [ 3 , 4 ] Many researchers have sought factors influencing the functional recovery of patients with extensive volar forearm lacerations. Advanced patient age, more proximal injuries, injuries to the ulnar nerve (compared to the median nerve), injuries to multiple nerves, and concomitant injuries to tendons and arteries predispose to poor outcomes.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting functional outcomes after surgery to repair extensive volar forearm lacerations with nerve injuries identified via quantitative and qualitative methods

2023

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Objectives We aimed to investigate factors affecting the functional outcomes of patients with extensive volar forearm lacerations combined with nerve injuries who underwent surgery. Patients and methods Between January 2012 and December 2018, a total of 71 patients (58 males, 13 females; mean age: 41±12.1 years; range, 20 to 66 years) with extensive volar forearm lacerations treated in our center were retrospectively analyzed. Demographic data and injury details of the patients were recorded. The functional results were quantitatively evaluated using the Rosén-Lundborg protocol (RLP) and qualitatively evaluated using the Quick Disability of Arm, Shoulder, and Hand (QuickDASH) scale. Results The mean follow-up time 69.8±36.7 (range, 18 to 148) months. The mean final RLP and QuickDASH scores were 2.17±0.4 and 8.03±10.55, respectively. There were no major complications such as infection, necrosis, re-rupture of a structure, or amputation. Patients with combined median and ulnar nerve injuries had poorer RLP scores than the others. Patients with combined median and ulnar nerve injuries, combined radial and ulnar arterial injuries, and who were of low education status, had lower QuickDASH scores than the others. Conclusion The main factors affecting long-term functional outcomes are a combined artery or nerve injury and a low education status. Favorable results can be achieved with the cooperation of experienced surgeons and hand rehabilitation specialists for patients with severe hand injuries.

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

Cited by 4 publications

References 33 publications

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

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

Socioeconomic factors and outcome after repair and reconstruction of digital and major nerve trunk injuries in the upper limb

Factors affecting functional outcomes after surgery to repair extensive volar forearm lacerations with nerve injuries identified via quantitative and qualitative methods

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