Nerve Lacerations

Selected Features of Our Program

Evaluation and Diagnosis

Cuts from as simple as kitchen knives in the hand to as serious as glass in the forearm can cause lacerations from individual digital nerves all the way to the major nerves of the arm. The functional loss that occurs is determined by which nerve is cut and how important that nerve is to the patient. The higher up in the body the nerve is injured the more serious the consequences. Symptoms include pain, weakness, loss of feeling and strength, and inability to perform certain functions. The diagnosis is made by an expert in nerve surgery during the physical examination process. This should happen right away after injury. Wasted time can change the final outcome and the treatment possibilities. Electrical nerve testing can add information regarding location and severity of injury.

Treatment and Recovery

Once the location and pattern of nerve injury are identified, surgery to repair the nerve is planned. If damage has been extensive or a significant amount of time since the initial injury has been lost, then repair of the original two ends of the nerve may not be possible. In this case nerve grafting or nerve transfer are two options that exist to solve the problem. The surgeon attempting to solve this type of problem must have considerable experience in reconstructive microsurgery and be familiar with all the modern options to deal with different patterns of nerve injury. Surgery is done with a powerful microscope under high magnification. Sutures smaller than the eye can see are used to repair the nerve fibers. After repair, new nerve fibers must grow from the location of injury down the arm to reach muscles for strength or the fingertips for feeling. These lost functions will not return for quite some time as the rate of nerve growth is only an inch a month. In some situations with very high nerve injuries in certain patients, the patient may chose an alternative strategy to nerve repair. Transfer of tendons to substitute for muscle functions that have been lost can be a good solution to a difficult problem. All these options and the expected outcome should be discussed thoroughly between the patient and the nerve surgeon. Good treatment planning is the key to success for solving nerve lacerations.