Joyal Jose1, Sabu Chaniveliyil Parameswaran2, Aniraj Rajappan3
BACKGROUND
Peripheral nerve injuries (PNIs) often accompany trauma to limbs and is a major
cause of morbidity. Various surgical techniques are described for nerve repair and
various factors influence the functional outcome after repair. This study intends to
assess the functional outcome following PNI repair and various factors affecting
the final outcome post repair. In this study we wanted to assess the functional
outcome of PNI repair done at our institute.
METHODS
This is a prospective observational study conducted at the Department of Plastic
and Reconstructive Surgery, Government Medical College, Thiruvananthapuram,
India, from September 2017 to September 2019 (24 months) in patients with a
diagnosis of traumatic peripheral nerve injury. Data collected were analysed by
statistical programme for social sciences (SPSS) version 20. Quantitative variables
were expressed in mean & standard deviation (SD) and qualitative variables were
expressed in proportions. Associations were tested by chi-square test.
RESULTS
A total of 100 patients were studied. Overall satisfactory sensory outcome was
found to be 45.2% in median nerve and 45.5 % in ulnar nerve injuries (P value -
0.492). Overall satisfactory motor outcome was found to be 45.2 % in median
nerve and 36.3 % in ulnar nerve injuries (P value - 0.391). Age < 40 years was
found to be significantly associated with a good sensory and motor recovery.
Diabetes mellitus was associated with a poor sensory and motor outcome
compared to patients without any comorbidities. Use of nerve grafts was
associated with less sensory recovery compared to primary nerve coaptation (P
value - 0.496). Nerve repairs done between 4 - 7 days of injury had better sensory
and motor outcome.
CONCLUSIONS
Traumatic peripheral nerve repair has a variable functional outcome and is
dependent on various factors like age and other patient related factors,
mechanism of injury and the type of nerve repair. Accurate diagnosis, attention to
detail and timely intervention can improve the overall functional outcome.
