Long standing nerve injury

Long standing nerve injury: Although sensory nerve repairs may restore sensation sensory recovery even after considerable treatment delays, there is a limited window of opportunity for functional nerve recovery in at least three situations. 1. Over time, muscles paralyzed by nerve injury lose their capacity to recover. The further from the hand the nerve is injured, the longer it takes for nerve fibers to grow back down to the paralyzed muscles. Functional muscle recovery is unlikely to occur in muscles paralyzed for over eighteen months. Taking into account the average rate of nerve recovery, a rough guide is that if the sum of Number of months between injury and surgery + Distance in inches between injury site and muscle belly is greater than eighteen, muscle recovery is not likely. Fortunately, this guide is not always true. 2. If fixed joint contractures have developed as a result of paralysis, muscle recovery is unlikely to result in normal motion, even if the contractures are surgically released. Common situations include proximal interphalangeal joint contracture in ulnar nerve palsy or first web space contracture in median nerve palsy. 3. If an adult patient has developed extremity disuse due to long standing anesthesia or chronic pain, nerve repair is unlikely to restore function. Discussion Home Page