Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity

Abstract

BackgroundPeripheral nerve injury in the upper extremity is linked to high socioeconomic burden, yet cost-analyses are rare and from small cohorts. The objective of this study was to determine the costs and long-term socioeconomic effects of peripheral nerve injuries in the upper extremity in Germany. MethodsWe analyzed data of 250 patients with 268 work-related upper extremity nerve injuries from acute treatment to long-term follow-up on rehabilitation, sick-leave and disability-pension. ResultsPatients were on average 39.9±14.2 years old, male (85%) and mean inpatient treatment was 7±6 days. Location of nerve was 8% (N = 19) proximal to the wrist, 26% (N = 65) at the wrist and metacarpus, and 66% (N = 166) at phalangeal level. Acute in-patient treatment for (single) median nerve injury accounted for 66% with hospital reimbursement of 3.570€, ulnar nerve injury for 24% and 2.650€ and radial nerve injury for 10% and 3.166€, all including finger nerve injuries. The remaining were combined nerve injuries, with significantly higher costs, especially if combined with tendon 5.086€ or vascular injury 4.886€. Based on location, nerve injuries proximal to the wrist averaged 5.360±6.429€, at the wrist and metacarpus 3.534±2.710€ and at the phalangeal level 3.418±3.330€. 16% required rehabilitation with average costs of 5.842€ and stay of 41±21 days. Sick leave was between 11-1109 days with an average of 147 days with socioeconomic costs of 197€/day, equaling on average 17.640€. 30% received a mean yearly disability pension of 3.187€, that would account to 102.167€ per lifetime.

Effects of Timing of Nerve Injury and Repair in Neonatal and Adult Brachial Plexus Injury Models

“…Combined forearm injuries of median and ulnar nerves produce more severe deficits and as they are usually associated with injured tendons and/ or vessel injury that require more complex assessment, intervention, and rehabilitation. Most of these injuries affect the median (50%) and ulnar nerves (44%) far more frequently than the radial nerve (20%) [16]. Socioecomonic costing are considerable including care delivery, loss of income, sick days, and long-term permanent disability.…”

Intramuscular injection of skeletal muscle derived extracellular matrix mitigates denervation atrophy after sciatic nerve transection

“… 2 Admittances for PNI affects males disproportionately, with rates being 85% men of 39.9 ± 14.2 years of age. 3 Slower and poorer quality healing in the aging population is also well reported. 4 , 5 Patients who experience nerve injury are then more likely to be diagnosed with chronic pain.…”

Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis

“…Current literature has focused on the efficacy of surgical and pharmacological treatments [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Regarding conservative treatments, most research evaluates the effects of electrophysical modalities (EM) in carpal tunnel syndrome (CTS) [22][23][24][25][26][27][28][29][30][31][32].…”