Module 7 - Hand Injuries

Nerve Injuries

Nerve injuries have been classified by Sunderland and Seddon. Commonly practitioners must decide whether the nerve injury is complete or incomplete and whether the nerve injury was sharp or crushing type. The methods to assess the nerve injury include light touch, pinprick, and two-point discrimination. Case of complete or incomplete division of the nerve should be referred for surgical management. Closed injuries of the nerve with a working diagnosis of neuropraxia or crushing type nerve injury can be followed clinically over the first two weeks to assess whether improvement is occurring.

Nerve repair is generally performed under magnification using microsurgical techniques. The standard repair is an epineural repair with 8-0 or 9-0 Nylon suture using the microscope or loop magnification. The person is immobilized for three to four weeks after the repair is carried out.

Author: Dr. SF Morris