Results of treatment for the posttraumatic neuropathies of peripheral nerves of the upper limb in children

Abstract

BACKGROUND: Peripheral nerve injuries are severe types of injury with potential life-long impairment, which is crucial in the pediatric population. Considering the lack of literature on pediatric nerve lesions, we analyzed the results of treatment for children with injuries of the peripheral nerves of the upper extremities in the Department of Microsurgery of the N.F. Filatov Children's City Clinical Hospital.
 AIM: This study aimed to evaluate the results of treatment for children with injuries of the peripheral nerves of the upper limb and to establish the relationship between the recovery of the function of the upper limb and the time elapsed from the moment of injury to surgery.
 MATERIALS AND METHODS: From 2017 to 2021, 114 patients with injuries of the peripheral nerves of the upper limb were treated in the Department of Microsurgery. The following data were extracted from the case histories and at the follow-up appointment: age, gender, level of damage, type of surgical intervention, period from the moment of injury to surgical intervention, and postoperative recovery of peripheral nerve functions. For the assessment of the sensory function of the nerves, a discriminatory two-point sensitivity test (Weber Test) and the Grigorovich scale were used. Electromyographic and ultrasound studies were also performed. Subjective feelings were assessed using the QuickDash questionnaire. The digital data were subjected to statistical processing.
 RESULTS: Analysis of the results of treatment for children with different periods from the moment of injury to surgery found no differences among the groups up to 14 days and more than 14 days (p 0.05). For further data analysis, the patients were divided into four groups depending on the period from the moment of injury to surgery: 1) up to 3 months, 2) from 3 to 6 months, 3) from 6 to 12 months, and 4) more than 12 months. No differences were found in the results (p 0.05). According to the evaluation of the effect of age on the recovery of peripheral nerve function, better recovery of sensitivity was observed at the age of up to 11 years compared with at the age of more than 11 years (p 0.05).
 CONCLUSIONS: Considering the lack of statistically significant differences in the results of treatment for children at various times from the moment of injury to surgery, we can conclude that a period of more than 12 months from the moment of injury to surgery does not influence the achievement of satisfactory results of reconstructive surgical interventions for peripheral nerves in children.