Secondary repair of ulnar nerve injury: 44 cases followed for 2 years

Barrios, Carlos; Amillo, S.; Pablos, Julio de; Canadell, J.

doi:10.3109/17453679008993065

Cited by 23 publications

(18 citation statements)

References 6 publications

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“…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]. …”

Section: Resultsmentioning

confidence: 99%

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

Zhu

et al. 2014

Neural Regen Res

114

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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.

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Section: Resultsmentioning

confidence: 99%

“…Outcomes are poorer when the repair is delayed by more than 1 year because muscle atrophy becomes irreversible at 1.5–2 years after the loss of innervation. Barrios et al[15] suggested that nerve repair should be performed within 3 months of the injury, and that the time from injury to repair should not exceed 1 year.…”

Section: Discussionmentioning

confidence: 99%

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

Zhu

et al. 2014

Neural Regen Res

114

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“…However, various publications claimed that there seems to be a better sensory recovery outcome if a nerve defect is treated primarily [25, 78]. Apart from that, there is an unfavorable prognosis for waiting more than 6 months or one year after performing a nerve repair [84–87]. For example, in some cases of strong contamination, secondary reconstruction is required.…”

Section: Discussionmentioning

confidence: 99%

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Paprottka

Wolf

Harder

et al. 2013

Plastic Surgery International

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Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-, muscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve reconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997 nerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior to another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve grafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients who underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery outcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique should be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a decision tree for digital nerve repair.

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“…The prognosis of peripheral nerve injuries depends on various factors such as the patient age, type of injury, severity of trauma, delay between the time of injury and repair, presence of additional organ injury and infection, affected nerve, distance between injury level and the affected organ, status of the anatomical integrity of the injured nerve, length of the defect between the proximal and distal ends and the experience and techniques of the surgeon (3,29,(30)(31)(32). Prognoses are better transection were associated with good recovery, whereas, neuroma-in-continuity or complete irregular transections were related to moderate or poor outcomes (8).…”

Section: █ Discussionmentioning

confidence: 99%

The outcomes of late term surgical treatment of penetrating peripheral nerve injuries

Gezercan¹,

Menekşe²,

Ökten³

et al. 2015

Turkish Neurosurgery

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In previous studies, the incidence of PNI has been reported to be 13 to 23 per 100 000 individuals per year. PNIs have been estimated to affect between 1.64% and 2.8% of all trauma patients (24,31). PNI is a common problem, especially in young adult men, and may cause serious disability in this productive age group unless the injured nerve is repaired (1, 22, 24). █ INTRODUCTIONPeripheral nerve injury (PNI) is still a significant cause of morbidity and disability throughout the world. Physical trauma, including traffic accidents and injuries due to sharp and penetrating objects such as broken glass, gunshots, falls and fractures, is the most common cause of PNI AIm: The aim of this retrospective study was to evaluate the follow-up results of patients who received late-term surgical treatment for peripheral nerve lesions caused by penetrating injuries. mATERIAl and mEThODS:The study included 25 patients who underwent surgery for peripheral nerve injuries in our clinic between 2007 and 2013. The patients were evaluated with respect to age, gender, etiology of the trauma, the affected nerve, clinical examinations, electrophysiological findings, surgical techniques and functional outcomes. RESUlTS:The study included 30 nerves of 25 patients (19 male, 6 female; mean age 30.1 years). The mean time between the initial injury and admission to our clinic was 11.5 months (range, 3 to 30 months). Cuts caused by glass were the most common cause of injury (68.5%). The most commonly injured nerves in our patients were the median nerve (43.4%) and ulnar nerve (26.6%). external neurolysis and decompression were performed in eleven patients, epineurotomy and internal neurolysis were performed in eight patients, epineural repair was performed in fourteen patients, fascicular repair was performed in three patients, and interfascicular anastomosis using sural nerve grafting was performed in five patients. Postoperative motor strength and electrophysiological analyses showed significant improvements. Better outcomes were obtained in cases with median nerve injuries rather than other nerve injuries. Additionally, patients undergoing external neurolysis and decompression exhibited better outcomes than those undergoing other surgical approaches. CONClUSION:Although surgical treatment is recommended as early as possible for peripheral nerve injuries, late-term surgical treatments may provide positive outcomes.

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Secondary repair of ulnar nerve injury: 44 cases followed for 2 years

Cited by 23 publications

References 6 publications

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

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

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

The outcomes of late term surgical treatment of penetrating peripheral nerve injuries

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