Evaluation of Traumatic Injuries of Median and Ulnar Nerves at the Wrist after Surgical Repair: Ultrasound and Electrophysiological Correlation

Abstract

Aims: To quantify the contribution of ultrasonography (US) as a complementary tool to electrodiagnostic evaluation of traumatic lesions of median and ulnar nerves after surgical repair" 
 Patients and Methods: The study included a total of 50 nerves from 40 patients with traumatic injury of wrist median and/ or ulnar nerves. Patients were evaluated at one and three months after primary nerve repair clinically, electrophysiological, and US examinations.
 Results: No significant difference (p = 0.125) was found between classification of injury by electrodiagnosis and by US. Good agreement between clinical assessment of the motor power and the severity of injury based on electrodiagnosis was found. Moderate agreement between clinical assessment of motor power and continuity of the repaired nerve based on US was noted. Good agreement between the severity of the injury by electrodiagnosis and the continuity of the repaired nerve by the US (p <0.001*) was detected. The sensitivity of US in detecting nerve continuity was 87.9% one month after repair and 80% after three months.
 Conclusion: As a supplement to electrodiagnostic testing, the US can offer a noninvasive and complementary tool for assessing post-operative repair of traumatic nerve lesions with respect to their exact location, course, continuity, extent, and neuroma formation and can be of value in the visualization of the morphological abnormalities associated with nerve injuries, including swelling and perilesional scar tissue formation.