Orthopedic & Muscular System: Current Research
Open Access
ISSN: 2161-0533
ISSN: 2161-0533
Abdallah Attia
Zagazig University, Egypt
Posters & Accepted Abstracts: Orthop Muscular Syst
Objective: To evaluate the clinical results and test the hypothesis that the use of an operating microscope improves the results of peripheral nerve repair. Design: A prospective and retrospective clinical and operative study was conducted. Patients & Methods: Forty-two patients with 52 median and ulnar nerve injuries were treated by direct nerve repair with microscope (26 nerves) and without microscope (26 nerves). In 10 patients, there were ipsilateral combined median and ulnar nerve injuries. The mean age of the patients at time of nerve repair was 29 years (range 11 to 50 years). There were 29 male and 13 female patients. Forty patients were right handed and 2 left handed. Causes of nerve injury were glass cut in 39 patients, knife injury in 3 patients. Delay between injury and repair was 0-48 hours (mean; 10.5 hours). Level of injury was at the wrist in 38 injuries; at the distal �?½ of forearm in 9 injuries, at the elbow in 2 injuries and above the elbow in 3 injuries. All nerves were repaired by direct nerve repair without nerve graft. The mean follow up period was 58 months (range, 7 to 140 months). Results: Results of nerve repair were evaluated using clinical tests (motor and sensory), timed functional tests, measurement of sudomotor activity by skin resistance meter, and assessment of activity of daily life (ADL) of the hand. Overall results were excellent in 12 hands (23%), good in 14 hands (27%), fair in 19 hands (13%), and poor in 7 hands (13%). Conclusions: Microscopic nerve repair gives better functional recovery, motor power and localization test score than nerves repaired without microscope. There was no significant difference in sensory and sudomotor recovery in both groups. The age of the patients, level of injury and associated vascular injury influence the outcome of nerve repair. Functional recovery continues to improve for at least 4 years after nerve repair.
Email: abdallah.attia2525@yahoo.com