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2018 ; 22
(ä): 17-156
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Nerve Transfer Surgery for Penetrating Upper Extremity Injuries
#MMPMID29702048
Karamanos E
; Rakitin I
; Dream S
; Siddiqui A
Perm J
2018[]; 22
(ä): 17-156
PMID29702048
show ga
CONTEXT: Nerve transfer surgery is an option for repair of penetrating injuries
of the upper extremity. In the right setting, it has advantages over tendon
transfers and nerve grafting. OBJECTIVE: To review our experience since 2006 of
nerve transfer surgery in the upper extremities. DESIGN: We included cases
performed to repair penetrating trauma within three months of injury with at
least three years' follow-up. MAIN OUTCOME MEASURES: Preoperative and
postoperative muscle strength of the affected extremity. RESULTS: All 16 patients
were males aged 16 to 43 years. Six patients underwent nerve transfer surgery
because of elbow flexion; 5, finger extension; 3, finger flexion; and 2, wrist
pronation. Nine patients (56%) had associated vascular injury, and 4 (25%) had
fractures. Average follow-up was 6 years. No perioperative complications
occurred. Patients had a mean of 3.7 operations after the initial trauma. All
patients received physical therapy. All patients improved from 0 of 5 muscle
strength preoperatively to a mean of 3.8 (range = 2/5 to 5/5) within 1 year after
surgery. In all cases, strength was maintained, and 8 (50%) had continued
improvement after Year 1. Ten (63%) returned to their previous employment level.
Mean Disabilities of the Arm, Shoulder and Hand score improved from 68 to 83
postoperatively. CONCLUSION: Nerve transfer is a safe, effective technique for
correcting penetrating trauma-related nerve injury. In appropriate patients it
offers advantages over other techniques. Outcomes can be maintained long term,
and many patients can return to their previous level of function.