Primary and Delayed Repair and Nerve Grafting for Treatment of Cut Median and Ulnar Nerves

Abstract

Traumatic cutting of peripheral nerves of median and ulnar in forearm and wrist can cause disablating sensory and motor disorders in patients' hands. We conducted the present study to compare the results of three surgical methods for repair of injured median and ulnar nerves. We studied 85 patients aged 12-59 years (average, 34 +/- 18 years) with 105 cut median and ulnar nerves at forearm and wrist presenting to Tabriz Shohada hospital from 1994 to 2003. The patients followed for 2-10 years. Sixty patients (65 nerves) underwent primary repair, 16 (25 nerves) treated with delayed method and 9 (15 nerves) received nerve graft. Success was obtained in all patients underwent primary repair. The excellent results were common in younger patients. Of 65 nerves (60 patients) repaired by primary method, 25 had excellent result. Of 16 patients 25 nerves (16 patients) underwent delayed repair, 7 was unsuccessful. Of 15 nerves (9 patients) underwent delayed repair, 5 was unsuccessful. It is concluded that the recovery following primary repair was faster than other methods. For reaching excellent results in repairing peripheral nerves, it is important to considering all rules needed for repairing cut peripheral nerves, as well as accurate evaluation and correct repair of injured surrounding soft tissue such as tendons and their synovium and injured vessels.

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

“…Of these, 126 were selected for review of the full text after primary screening, and 67 were judged to meet the criteria for inclusion in the present study[78910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970717273]. …”

Rehabilitative Surgery

“…In 2010, Mohseni et al in Iran reported that early primary repairs have the best results with all 60 patients showing some recovery and 25/65 (38 %) having excellent results, compared to poor recovery and 7/25 (28 %) failures with delayed primary repair and 5/15 (33 %) failures after delayed nerve graft [231]. In 2014, George and Boyce reviewed 28 studies (1577) of peroneal nerve repairs [111].…”

Nerve Repair and Orthodromic and Antidromic Nerve Grafts: An Experimental Comparative Study in Rabbit

“…erefore, considering a 50% regeneration rate in the proximal and distal repair sites and the cross-sectional area ratio of the two nerves, the estimated success rate is only 13%. In a comparative study of primary repair, delayed repair, and nerve graft, good to excellent results were achieved in 78% of the primary repair group but only 33.3% of the nerve graft group [22]. Similarly, in another study comparing microsuture, interpositional nerve graft, and laser solder weld repair of the rat inferior alveolar nerve, interpositional nerve graft was the least effective [23].…”