J Hand Microsurg 2020; 12(01): 27-31
DOI: 10.1055/s-0039-1692928
Original Article

Long-Term Outcomes following Pediatric Peripheral Nerve Injury Repair

Benjamin Langridge
1   Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
,
Michelle F. Griffin
1   Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
2   Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
3   Division of Surgery & Interventional Science, University College London, London, United Kingdom
,
M. A. Akhavani
1   Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
,
Peter E. Butler
1   Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
2   Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
3   Division of Surgery & Interventional Science, University College London, London, United Kingdom
› Author Affiliations

Abstract

Introduction Peripheral nerve injuries in children are uncommon and can be challenging to diagnose. There is a paucity of data on long-term sensorimotor and functional outcomes following surgical repair. We present a 12-year retrospective analysis of pediatric peripheral nerve repair with long-term functional outcomes.

Materials and Methods We performed a retrospective analysis of pediatric patients with peripheral nerve injury requiring surgical repair. Clinical records were analyzed for procedure type, time to surgery, mechanism of injury, postoperative recovery, and complications.

Results A total of 108 patients were identified and 87 patients were included. Out of 87 patients, 83 (95.4%) had partial or complete sensorimotor recovery at final follow-up and 4 did not improve. Minor complications occurred in 10.3% of patients, all resolved with conservative management. Mechanisms of injury were predominantly lacerations with sharp objects or crush injuries. Age at time of injury was inversely correlated with sensorimotor recovery, and time to surgical repair was not.

Conclusion Surgical repair with long-term hand therapy results in excellent functional outcomes following pediatric peripheral nerve injury. A low threshold for exploration and repair should be used in instances of diagnostic uncertainty. Timing of surgical repair is dependent on a patient’s clinical presentation; however, repair within 48 hours is sufficient for optimal sensorimotor recovery.



Publication History

Received: 07 November 2018

Accepted after revision: 02 May 2019

Article published online:
07 July 2019

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  • References

  • 1 Valencia J, Leyva F, Gomez-Bajo GJ. Pediatric hand trauma. Clin Orthop Relat Res 2005; (432) 77-86
  • 2 Nofsinger CC, Wolfe SW. Common pediatric hand fractures. Curr Opin Pediatr 2002; 14 (01) 42-45
  • 3 Hosalkar HS, Matzon JL, Chang B. Nerve palsies related to pediatric upper extremity fractures. Hand Clin 2006; 22 (01) 87-98
  • 4 Lundborg G, Rosén B. 0Hand function after nerve repair. Acta Physiologica 2007; 189: 207-217 DOI: 10.1111/j.1748-1716.2006.01653.x.
  • 5 Kaufman Y, Cole P, Hollier L. Peripheral nerve injuries of the pediatric hand: issues in diagnosis and management. J Craniofac Surg 2009; 20 (04) 1011-1015
  • 6 Bulut T, Akgün U, Çıtlak A, Aslan C, Şener U, Şener M. Prognostic factors in sensory recovery after digital nerve repair. Acta Orthop Traumatol Turc 2016; 50 (02) 157-161
  • 7 Chemnitz A, Dahlin LB, Carlsson IK. Consequences and adaptation in daily life - patients’ experiences three decades after a nerve injury sustained in adolescence. BMC Musculoskelet Disord 2013; 14: 252
  • 8 Weinzweig N, Chin G, Mead M. et al. Recovery of sensibility after digital neurorrhaphy: a clinical investigation of prognostic factors. Ann Plast Surg 2000; 44 (06) 610-617
  • 9 Lundborg G, Rosén B. Sensory relearning after nerve repair. Lancet 2001; 358 (9284) 809-810