Comparative Strength of Muscles with Similar Function: A Study on Peripheral Nerve Injuries of the Upper Extremity

AbstractBackground and aimsAside from the long term side effects of a nerve injury in the upper extremity with devastating consequences there is often the problem of chronic neuropathic pain. The studies concerning the prevalence of persistent pain of neuropathic origin after peripheral nerve injuries are sparse. The prevalence and risk factors associated with chronic neuropathic pain after nerve injuries in the upper extremity were assessed.MethodsA standardized data collection template was employed prospectively and retrospectively for all patients with traumatic nerve injuries accepted at the Hand Surgery Department, Uppsala, Sweden between 2010 and 2018. The template included demographic data, pain diagnosis, type of injured nerve, level of injury, date of the lesion and repair, type of procedure, reoperation, time since the procedure, S-LANSS questionnaire (Self report-Leeds Assessment of Neuropathic Symptoms and Signs), RAND-36 (Item short form health survey), QuickDASH (Disability of Shoulder, Arm and Hand) and additional questionnaires concerned medication, pain intensity were sent to 1,051 patients with nerve injuries. Partial proportional odds models were used to investigate the association between persistent pain and potential predictors.ResultsMore than half of the patients undergoing a surgical procedure developed persistent pain. Prevalence of neuropathic pain was 73% of the patients with pain (S-LANSS ≥ 12 or more). Multivariate analysis indicated that injury of a major nerve OR 1.6 (p = 0.013), years from surgery OR 0.91 (p = 0.01), younger age OR 0.7 (p < 0.001), were the main factors for predicting pain after surgery. The type of the nerve injured was the strongest predictor for chronic pain with major nerves associated with more pain (p = 0.019).ConclusionsA high prevalence of chronic pain and neuropathic pain with a negative impact on quality of life and disability were found in patients after traumatic nerve injury. Major nerve injury, younger age and less time from surgery were predictors for chronic pain.

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Ultrasonographic evaluation of the iatrogenic peripheral nerve injuries in upper extremity

European Journal of Radiology ◽

10.1016/j.ejrad.2008.10.038 ◽

2010 ◽

Vol 73 (2) ◽

pp. 234-240 ◽

Cited By ~ 19

Author(s):

Nuri Karabay ◽

Tulgar Toros ◽

Yalçın Ademoğlu ◽

Sait Ada

Keyword(s):

Peripheral Nerve ◽

Upper Extremity ◽

Peripheral Nerve Injuries ◽

Nerve Injuries

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Evaluation of pediatric upper extremity peripheral nerve injuries

Journal of Hand Therapy ◽

10.1016/j.jht.2014.09.003 ◽

2015 ◽

Vol 28 (2) ◽

pp. 135-143 ◽

Cited By ~ 9

Author(s):

Emily S. Ho

Keyword(s):

Peripheral Nerve ◽

Upper Extremity ◽

Peripheral Nerve Injuries ◽

Nerve Injuries

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Primary Repair of Upper Extremity Peripheral Nerve Injuries: An NSQIP Analysis From 2010 to 2016

Hand ◽

10.1177/15589447211044768 ◽

2021 ◽

pp. 155894472110447

Author(s):

Ryan Brennan ◽

Jordan Carter ◽

Gilberto Gonzalez ◽

Fernando A. Herrera

Keyword(s):

Peripheral Nerve ◽

Upper Extremity ◽

Complication Rate ◽

Primary Repair ◽

Nerve Repair ◽

Multiple Injury ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Improvement Program ◽

Injury Group

Background To identify the rate of 30-day complications after primary repair of upper extremity peripheral nerve injuries, associated diagnoses, and postoperative complication rate. Methods The American College of Surgeons National Surgical Quality Improvement Program database was reviewed from 2010 to 2016. Current Procedural Terminology codes consistent with primary nerve repair of the upper extremity were identified and included in the analysis. Patient demographics, comorbidities, type of procedure (elective/emergent), wound class, operative time, and 30-day complications were recorded. Patients with isolated upper extremity nerve injuries (isolated) were compared with those with peripheral nerve injuries in addition to bone, tendon, or soft tissue injuries (multiple). Results In all, 785 patients were identified as having upper extremity nerve repairs (0.16%). Of them, 64% were men and 36% were women; the average patient age was 40 years. The most common indication for surgery was injury to the digits (54% of cases). Thirty-day adverse events occurred in 3% of all cases. Isolated nerve injury occurred in 43% of patients, whereas 57% had additional injuries. The multiple injury group had a significantly higher complication rate compared with the isolated group (1% vs 4.5%) ( P = .007). Repair of tendon at forearm or wrist was the most common concurrent procedure performed. Conclusions Thirty-day complications among upper extremity peripheral nerve injuries are low, accounting for 3% of cases. Return to the operating room accounted for nearly half of all complications. Patients in the multiple injury group accounted for more than half of these and had a significantly higher complication rate compared with patients with isolated nerve injuries.

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