Timing of surgery in peripheral nerve injury of the upper extremity

J Hand Surg Eur Vol. 2024 Jun;49(6):712-720. doi: 10.1177/17531934241240867. Epub 2024 Apr 20.

Abstract

Peripheral nerve injuries present a complex clinical challenge, requiring a nuanced approach in surgical management. The consequences of injury vary, with sometimes severe disability, and a risk of lifelong pain for the individual. For late management, the choice of surgical techniques available range from neurolysis and nerve grafting to tendon and nerve transfers. The choice of technique utilized demands an in-depth understanding of the anatomy, patient demographics and the time elapsed since injury for optimized outcomes. This paper focuses on injuries to the radial, median and ulnar nerves, outlining the authors' approach to these injuries.Level of evidence: IV.

Keywords: Peripheral nerve; nerve injury; nerve repair timing; treatment algorithm.

Publication types

  • Review

MeSH terms

  • Humans
  • Median Nerve / injuries
  • Median Nerve / surgery
  • Neurosurgical Procedures / methods
  • Peripheral Nerve Injuries* / surgery
  • Radial Nerve / injuries
  • Radial Nerve / surgery
  • Time-to-Treatment
  • Ulnar Nerve / injuries
  • Ulnar Nerve / surgery
  • Upper Extremity* / injuries
  • Upper Extremity* / innervation
  • Upper Extremity* / surgery