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What is peripheral nerve injury?

Nerves carry messages from the brain to the rest of the body, allowing the body to experience sensations, as well as assisting the muscles in the coordination of movement. If there is damage to a nerve in the hand, it can interfere with these functions. Damage to the nerves in the hand can result from a deep cut, a crush, or a neuroma (injury to the nerve itself), as well as congenital issues.

What to expect

During the consultation with your physician, your hand will be examined and may require additional studies, often in conjunction with our neurology department, such as:

  • Electromyography (EMG) - A diagnostic test performed by a neurologist to assess the health of muscles and the nerve cells that control them. EMG results show nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.
  • Nerve conduction study – Also called a nerve conduction velocity test, a nerve conduction study measures the speed at which an electrical impulse is conducted through a nerve. This test can determine the extent of nerve damage. Nerve conduction study is usually conducted by a neurologist.
  • Magnetic resonance imaging (MRI) – Different from X-rays and CAT scans, MRIs use a magnetic field and radio waves to generate an image instead of radiation. You’re placed in a tube and radio waves are aimed at your hand and wrist, causing them to vibrate. A computer then translates the rate of the vibrations into a high-definition image.

After physical examination and evaluation of the results of the diagnostic tests, your doctor will recommend a course of treatment.

There are several types of treatments for peripheral nerve injury in the hand, including:

  • Coapt (primary repair) – This repair is the simplest of the surgeries. If the nerve had a clean cut and the severed ends are near each other, the nerve is repaired by stitching them back together.
  • Nerve graft - If the cut to the nerve is not a clean one that can be repaired, a nerve graft may be necessary. A nerve graft involves borrowing a nerve from somewhere else in the body and using it to replace the damaged one.
  • Nerve transfer – A nerve transfer involves using a nearby nerve to take over the job of restoring function and sensation to the area.
  • Muscle transfer – When a muscle is unresponsive, a muscle transfer involves using a nearby muscle to restore function to the area.

Complications

Risks for peripheral nerve injury repair surgery are rare and are similar to those for any surgery, including problems with anesthesia, infection and blood loss. In addition, there is a small chance that the surgery may be unsuccessful and function/sensation will not be restored.

Recovery

Recovery varies from case to case, depending on the type and severity of your injury. Your physician will discuss your unique situation with you during your consultation and after your surgery. Wound care, maintaining joint mobility and participating in hand therapy are typically discussed.

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