Nerve injuries of the upper extremity and hand

Abstract

A nerve injury has a profound impact on the patient’s daily life due to the impaired sensory and motor function, impaired dexterity, sensitivity to cold as well as eventual pain problems.To perform an appropriate treatment of nerve injuries, a correct diagnosis must be made, where the injury is properly classified, leading to an optimal surgical approach and technique, where timing of surgery is also important for the outcome.Knowledge about the nerve regeneration process, where delicate processes occur in neurons, non-neuronal cells (i.e. Schwann cells) and other cells in the peripheral as well as the central nervous systems, is crucial for the treating surgeon.The surgical decision to perform nerve repair and/or reconstruction depends on the type of injury, the condition of the wound as well as the vascularity of the wound.To reconnect injured nerve ends, various techniques can be used, which include both epineurial and fascicular nerve repair, and if a nerve defect is caused by the injury, a nerve reconstruction procedure has to be performed, including bridging the defect using nerve-grafts or nerve transfer techniques.The patients must be evaluated properly and regularly after the surgical procedure and appropriate rehabilitation programmes are useful to improve the final outcome.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160071. Originally published online at www.efortopenreviews.org

Beneficial effects of fish oil enriched in omega-3 fatty acids on the development and maintenance of neuropathic pain

“…In the case of the CCI + ω‐3 group, where the number of Schwann cell nuclei increased, this may have been accompanied by the upregulation of a large number of different trophic factors that supported the axons during regrowth . In the longitudinal sections, nerves from the CCI group appeared interrupted and revealed a detachment with a distorted perineurium, which may have been the result of a disorganized regeneration of axons together with a mixture of cells, such as Schwann cells, endothelial cells, macrophages and fibroblasts (better known as neuroma) and often associated with an increased sensitivity and spontaneous or evoked neuropathic pain . The CCI + ω‐3 group, however, revealed no evidence of neuroma formation.…”

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

“…Neuroapraxia [ 36 ] is functional damage of the nerve; axonal structures and connective tissue are intact. Anatomically, damage to the myelin has been proposed as a mechanism.…”

Ulnar Nerve Injury and Froment’s Test: A Case Report

“…In terms of peripheral extremity injuries identified during the initial trauma survey, these must always be evaluated for possible skeletal, vascular, and neurological compromise. Timely recognition of such injuries and early, appropriate referrals have a positive impact on patient outcomes, particularly in preventing long-term disability [6,7].…”