Nerve Surgery
The “string” on the bottom is a nerve retractor, wrapped around a nerve of the brachial plexus.Vertically in the center is nerve with the cabled sural nerve graft in place. The nerve above the repair is ruddy and the graft distally, below, is comprised of two parallel parts, like lying two spaghetti strands side by side.
What is Nerve Injury?
Nerve Injury is the result of damage to a peripheral nerve. Nerve Injury may be partial or complete. Partial Nerve Injury means that some amount of the nerve is still intact, so the potential for the nerve to heal on its own may remains in some cases, but not in others. Complete Nerve Injury means that no component of the nerve remains intact, so there is no possibility at all for the nerve to heal itself.
Symptoms of Nerve Injury
Nerves provide sensation and power muscles. Nerve Injury thus results in a feeling of numbness or weakness, or both. Depending on which nerve has been injured and where the site of injury is located, the symptoms can involve a large area of numbness and weakness, or a very small area.
Common Causes of Nerve Injury
A variety of causes lead to Nerve Injury. Traumatic causes include laceration, compression, and stretch injuries. These can occurs from knives, broken glass, passing out while lying on the arm, and motorcycle accidents. Other causes can be due to degenerative processes, systemic disorders, as well as inherited predisposition and congenital anatomic variations.
Diagnosing Nerve Injury
Speaking with you to understand if an accident occurred or whether there has been non-traumatic numbness and weakness is essential. Localizing the area of the hand and upper extremity that is affected is important to arrive at the correct diagnosis. In some cases more than one nerve may be injured. The physical exam must be thorough to individually assess numerous muscles and nerve endings.
A Nerve Conduction Study (NCS) can provide additional help with evaluating the degree and location of nerve injury. X-rays will evaluate for underlying fractures or chronic degenerative changes of joints that can affect adjacent nerves.
A CT or MRI may be helpful as well. All of this information is synthesized with diagnostic proficiency to pinpoint the injured nerve(s), the cause and location of nerve injury, and associated injuries that may also have occurred.
Treatment Options for Nerve Injury
Traumatic injuries, especially lacerations, generally benefit from microsurgical repair. Direct repair of the injured nerve is the goal, but sometimes reconstructive techniques may be necessary, including nerve autografts, allografts, conduits, and transfers from neighboring healthy nerves, in order to optimize recovery of sensation and movement. Nerve Injury that is the result of chronic compression or a systemic illness may offer the opportunity to be managed conservatively before considering surgical treatment.
Conclusion
Nerve Injury can be serious and prompt diagnosis and treatment establishes the best opportunity for success. Call Dr. Pruzansky at 212-249-8700 to heal your injured nerve.