Contemporary Management of Peripheral Nerve Trauma

ABSTRACT

Peripheral nerve injury remains a significant cause of disability. Injuries often occur in young, otherwise healthy individuals. Currently, civilians compose the majority of evaluated cases, but significant injuries continue to occur during wartime. Some lesions recover spontaneously and others are helped by surgical repair; still others have persistent neurologic deficits even with optimal management. The evolution of imaging, predominantly the widespread availability of magnetic resonance imaging (MRI) and development of surface coils specific for nerve, may improve preoperative assessment of nerve damage. Intraoperative electrophysiologic assessment of nerve lesions is another advance that continues to evolve. Advances in neurotrophin physiology and better understanding of nerve regeneration have yet to yield significant improvements in repair but offer promise for the future. We review the contemporary management of peripheral nerve injury, focusing on treatment paradigms developed at the Louisiana State University Health Science Center, but also highlighting promising areas of research. The foundations for management of traumatic nerve injury remain constant. These include a thorough history and physical examination, appropriate radiographic assessment, electrophysiology assessment, and operative exploration when indicated.

KEYWORD

Peripheral nerve - nerve injury - nerve action potential

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