Primary and delayed repair and nerve grafting for treatment of cut median and ulnar nerves.

Abstract

Traumatic cutting of peripheral nerves of median and ulnar in forearm and wrist can cause disablating sensory and motor disorders in patients' hands. We conducted the present study to compare the results of three surgical methods for repair of injured median and ulnar nerves. We studied 85 patients aged 12-59 years (average, 34 +/- 18 years) with 105 cut median and ulnar nerves at forearm and wrist presenting to Tabriz Shohada hospital from 1994 to 2003. The patients followed for 2-10 years. Sixty patients (65 nerves) underwent primary repair, 16 (25 nerves) treated with delayed method and 9 (15 nerves) received nerve graft. Success was obtained in all patients underwent primary repair. The excellent results were common in younger patients. Of 65 nerves (60 patients) repaired by primary method, 25 had excellent result. Of 16 patients 25 nerves (16 patients) underwent delayed repair, 7 was unsuccessful. Of 15 nerves (9 patients) underwent delayed repair, 5 was unsuccessful. It is concluded that the recovery following primary repair was faster than other methods. For reaching excellent results in repairing peripheral nerves, it is important to considering all rules needed for repairing cut peripheral nerves, as well as accurate evaluation and correct repair of injured surrounding soft tissue such as tendons and their synovium and injured vessels.