Peripheral Nerve Injury -Repair and Reconstruction-Peripheral Nerve Injury -Repair and Reconstruction Overview

Peripheral Nerve Injury -Repair and Reconstruction Overview

Pdf Summary

Electrodiagnostic testing is used to evaluate peripheral nerve conditions. It includes nerve conduction velocities and electromyography. The objective of testing is to confirm the presence or absence of neuropathy and evaluate for nerve entrapment or compression, demyelinating processes, and diseases that cause axonal loss. Definitions related to electrodiagnostic testing include stimulator (device used for electrical stimulation), pick-up (electrode placed to detect nerve response), distal peak latency (time from stimulation to peak of waveform), onset latency (time from stimulation to onset of compound motor action potential), CMAP (waveform generated by muscle response to nerve stimulation), sensory nerve action potential (waveform generated by sensory nerve response to stimulation), conduction velocity (speed of stimulus transmission across a nerve segment), and more. Common peripheral nerves involved in upper extremity problems include suprascapular, long thoracic, musculocutaneous, radial, axillary, median, and ulnar nerves. The peripheral nervous system consists of neurons, Schwann cells, fibroblasts, and macrophages. Nerve injuries can be classified into different grades based on the degree of trauma. Nerve healing involves remyelination and axon regeneration. Timing of repair depends on the type of injury and observation may be an option in some cases. Repair involves debridement, approximation of nerve ends, alignment, and coaptation using sutures, fibrin glue, or nerve connectors. Conduits or nerve grafts can be used for larger gaps. Nerve transfers are used for reconstruction following proximal nerve injuries. Results of nerve repair show varied functional outcomes, with factors like patient age, regeneration length, size or gap, and time from injury to repair affecting the outcomes.

Keywords

Electrodiagnostic testing

Peripheral nerve conditions

Nerve conduction velocities

Electromyography

Neuropathy

Nerve entrapment

Demyelinating processes

Axonal loss

Nerve injuries

Nerve repair