Outcome of nerve repair in forarm and hand injuries

Abstract

Objectives: To determine the outcome of nerve repairs in terms of motor and sensory improvement in patients with nerve injuries at distal forearm and hand.

Methodology: This descriptive case series was conducted at department of Plastic Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from June 2016 to October 2016. Primary suturing was carried out on all those cases who presented in emergency with clean wound. Patients with crush injury and contaminated wounds were considered for secondary suturing. End to end nerve repair without tension was done in both primary and secondary suturing. Nerve graft applied where required. Data was recorded on the proforma and statistically analyzed using SPSS version 20.

Results: 28 patients (29.5%) were diagnosed as open nerve injury while 67 patients (70.5%) were diagnosed as closed nerve injury. Mean age of the patients was 34.3±4.9 year. Associated tendon injury or bone fracture was seen in 24 cases (25.3%). Three operative procedures were performed, primary suture in 18 (18.9%) cases, secondary suture in 55 (57.9%) cases and nerve graft in 22 cases (23.2%). Good outcome in terms of motor grade recovery was in 64 patients (67.3%) and in terms of sensory grade recovery in 59 patients (62.1%).

Conclusion: Nerve repair after nerve injuries represents a challenge to the plastic surgeons. Good motor and sensory outcome is observed in forearm and hand injuries in our local setup.