Evaluation of Microsurgery Results in Patients with Peripheral Nerve Injury, Talegani and Shafa Hospitals, kermanshah, Iran. (1992-1999)

Background & Objectives: Patients with peripheral nerve injury make up five percent of referrals to medical centers owing to accidents. Since peripheral nerve injury can lead to functional defect, therefore, there are many factors that should be considered for obtaining the best result of managements, e.g. degree of nerve injury, age, kind of nerve injury and date of surgery being out of our control. It is more than likely the best result of management could be obtained through the best technique of surgery_ substitution of old techniques for the most modern one, Microsurgery.  In this study, we have tried to report the result of management of 69 patients with peripheral nerve injury undergone microsurgery technique.

Materials and Methods: In this survey, 69 patients with an average age of 2.5 to 59 have been studied within 7 years. The patients were suffering from 82 traumas leading to upper extremity peripheral nerve injury. All nerve injuries, have been repaired via "end to end coaptation microsurgery technique" in form of perineuronal, fasicular, group fasicular nerve repair, or mix of the three methods, using 9-0, 10-0 Nylon string for most patients.All the patients were followed up through physical history, physical exam like Semmes-Weinstein Monofilament, Two -Point Discrimination, Moberg pick-up test, and performing EMG and NCV tests 35 months after microsurgery.

Results: 83% of patients were male. About half, underwent operation less than one week after accident. Sensory and functional recoveries were evaluated by using a modified British scale. We considered sensory recovery “good” for grades S3+ and S4 observed in 56 injured nerves, and functional recovery “good” for grades M3 and M4 in 48 injured nerves.

Conclusion: Having used microsurgery technique for peripheral nerve injury repair, only 20 percent of injured nerves had a complete sensory and functional recovery contributed to some variable factors such as delay to the repair of nerve, degree of nerve injury and age of patients.