Relevant factors in the treatment of digital nerve injury of the hand

Abstract

Introduction. In his work the orthopaedic surgeon deals with a large number of peripheral nerve injuries, especially of the upper extremity. Most of these injuries involve the hand (30%). Objective. The aim of the study was to analyze the influence of some factors (age, aetiology, level of injury, associated injuries) on surgical treatment outcome of digital nerve injury of the hand. Methods. At the Department for Microsurgery 72 hospitalized patients were operated on due to the injury of common palmar digital nerves and proper palmar digital nerves. All operations were performed within the first 48h after injury and primary neurosuture was done in all. Beside the evaluation of demographic parameters, we also assessed aetiology of injury, associated injuries, level of injury, as well as the vascular status of the injured finger. Functional recovery was measured by the Medical Research Council (MCR) scale (S0-S4). Results. We found a statistically significant difference in sensory recovery according to age and aetiology of injury (p<0.05). Better results of sensory recovery were detected in cases with undamaged artery or where anastomosis was done, but without statistical significance. There was no statistical significance difference regarding the level and associated injuries. Conclusion. Two major factors in the recovery of digital nerve function are patient’s age and mechanism of injury. Having in mind the limited degree of recovery, the patient should be precisely informed preoperatively on the nature of injury and realistically expected results.

Keywords

• digital nerves
• hand injury
• microsurgery
• neurosuture