Peripheral nerve injury of the forearm: etiology and lesional complexity aspects

Abstract

Introduction. Peripheral nerve disorders comprise a gamut of problems that significantly affect patient function and quality of life. Peripheral nerves are structures that suffer injuries similar to those seen in other tissues, resulting in important motor and sensory disabilities. It is estimated that the incidence of traumatic lesions is as high as 500.000 cases per year in some countries, where 2,8% of the patients become permanently disabled due to prolonged nerve regeneration time (Noble et al., 1998; Rodrígues et al., 2004) Aim of the study. Identification and examination of etiology and lesional complexity aspects in peripheral nerve injuries of forearm, as well as their independent contribution to obtained results after repair. Materials and methods. A retrospective study of 200 patients surgicaly treated during the period 2014-2016 in our clinic. From total amount of patients, 81% (162) were men and 19% (38) women. Age limits were between 17 and 83 years. Most frequently was affected ulnar nerve, being injured in 56% cases (112 patients). Lesion of median nerve was in 36.5 % cases (73 patients) and radial nerve - in 7.5% cases (15 patients). Results. In study group, the most frequently lesional mechanisms were by cutting in 78 % cases and traction or contusion in 22 % cases. Therewith was established that in 96% cases were associated a muscular or tendon injury, in 31.4% cases – open fractures of forearm bones and vascular lesions - in 48.6 % cases. Conclusions. In open injuries of the forearm the ulnar nerve is the most frequently injured, being often accompanied by damage of tendons and vessels. Complexity of trauma has a negative influence on primary survey, recovery and restoration of work capacities.