greek.doctor

Nerve repair

Revision as of 08:34, 13 September 2024 by Nikolas (talk | contribs) (Created page with "<section begin="traumatology" />After traumatic nerve injury, for example of the hand, '''surgical nerve repair''' is often indicated. However, immediate repair is not always appropriate; in many cases, delaying the repair a few weeks or months may be better. However, nerve repair should not be delayed more than six months, as beyond that time irreversible changes occur. Surgical nerve repair is indicated for neurotmesis and visibly damage...")
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

After traumatic nerve injury, for example of the hand, surgical nerve repair is often indicated. However, immediate repair is not always appropriate; in many cases, delaying the repair a few weeks or months may be better. However, nerve repair should not be delayed more than six months, as beyond that time irreversible changes occur.

Surgical nerve repair is indicated for neurotmesis and visibly damaged nerves. If the transection is sharp, immediate nerve repair is performed. If the transection is blunt, nerve repair should be delayed. If the nerve ends cannot be brought together without tension, a nerve graft should be used (from sural nerve).

Indications

Conservative treatment is indicated for:

  • Nerve injuries with neurapraxia or axonotmesis

Delayed repair is indicated for:

  • Nerve injuries with neurotmesis
  • Open injuries with blunt transection

Immediate repair is indicated for:

  • Open injuries with sharp (clean) transection

Grafts

If the gap between the nerve ends is large so that they cannot be brought together without tension, a nerve autograft or allograft should be used. Graft may be from the sural or antebrachial cutaneous nerves. If the ends can be brought together without tension graft is not necessary. However, it’s important to avoid tension on the nerve.