The results of the long-term repair of median and ulnar nerve of forearm laceration

ABSTRACTPeripheral nerve injuries in the forearm are one of the situations that can causefunctional loss and serious social problems. In our study, we retrospectively evaluatedautonomic, motor and sensory recovery of 50 patients that had ulnar and/or mediannerve injury in the level of between wrist and elbow, and treated in our clinic.Mean age of patients included was 33,16 (range: 7-71 years old), mean followup was 7,16 years (range: 1-17 years). 40 patients were male and 10 patients werefemale. The most common cause was glass cut (33,66%). In 30 cases (60%) injury wasin right upper extremity and in 20 cases (40%) injury was in left upper extremity. In 34patient (64%) dominant extremity was injured.50 of 150 patients that were treated because of ulnar and/or median nerve injury( in the level of between elbow and wrist, radial nerve injuries were excluded) between1996-2011 and that come to final visits and reached from hospital records wereretrospectively. There were median nerve injury in 21 patients, ulnar nerve injury in 19patients and both ulnar and median nerve injury in 10 patients. There were isolatednerve injury 8 in cases, both nerve and tendon injuries in 15 cases, nerve, tendon andartery injuries in 27 cases. 49 patients out of 50 patients underwent early primary repair.Nerve graft was applied during primary repair due to nerve defect in 3 cases of this 49patients. Due to late apply to hospital, neuroma excision and secondary repair wasperformed to 1 patient.Good and very good results according to Seddon assessment criteria weredetermined in 19 (90,5%) median nerve injuries, in 17 (89,5%) ulnar nerve injuries andin 4 (40%) both ulnar and median nerve injuries. Good and very good results accordingto Seddon assessment criteria were determined in 6 (75%) cases of isolated nerveinjuries group, in 14(93,3%) cases of both nerve and tendon injuries group, in 20 casesof nerve, tendon and artery injuries group. Cases analysed according to age groups, inage group range of 0-18 years very good results determined in all cases (%100), inpatients over the age of 46 good and very good results rate was only 55,5%.Stereognosis was present in 45% of patients included in the study. Pain waspresent according to VAS in 23 of 50 patients. PAM distance was not complete in 5patient (10%). Trophic changes were determined in 13 of 50 patients. Opposition wasbetween 0-5 degrees in 8 patient (16%).In patients included this study, statistically significant difference (p=0,012) wasobtained in terms of deformity of the affected peripheral nerves. Deformity wasobserved in 9 of 10 (90%) cases that both ulnar and median nerve injured.Key words: long-term results forearmsmedian and ulnarnerve injuries