Peripheral Nerves

Trauma

Traumatic nerve injury occurs from trauma such as sharp cuts by glass, breaking of major nerves while stretching, compression due to sitting in cramped postures, and penetrating wound such as with gunshots. Any injury to the peripheral nerve results in the loss of motor and sensory function. During any surgery accidental damage to the large nerves such as motor nerves can result in loss of movement and sensation. Pain is the most common symptom in traumatic nerve injuries and individuals may also experience weakness and numbness. Some factors that are considered before deciding to perform surgery are patient's age, if there is a tear in the nerve from the injury, or if there is a loss of function without disruption of the nerve.

Neurosurgery is performed after a complete diagnosis of the nerve. Magnetic resonance neurography (MRN) and electromyography (EMG) are the tests conducted to detect the abnormal nerve signals and nerve injuries. Pinch and grip strength measurements are assessed using appropriate tools to determine the muscle strength.

The surgery is performed on severed nerves and also on intact nerves with no electrical response in order to repair and regenerate the damaged nerve. The nerve ends of the motor and sensory nerves are joined together in cases of external injury to the nerve. The nerve that is cut or torn has fewer chances to regenerate. Radial nerves (supplies signals to upper limbs) and tibial nerves (supplies signals to lower limbs) recover fast after the surgery, while the peroneal nerves will heal over time. Better results can be obtained with earlier diagnosis and treatment. If the surgery is delayed then the recovery time will be increased. After the surgery the nerve is restored. The patient is instructed to exercise to gain strength of the muscles.

Surgery for traumatic nerve injuries may not pose major risks. Pain, inflammation, hematoma or clots at the wound are the most commonly observed risks. Analgesics and antibiotics are prescribed to relieve the pain and inflammation, respectively. Intramuscular injections (tripeptide, leupeptin) are given to facilitate the regeneration of nerve growth factors.