The Hip: Preservation, Replacement and Revision

Primary Nerve Repair



- Discussion:
    - in sharp clean wounds primary repair is indicated;
    - by definition primary repair is performed within 7 days of injury;
    - age of the patient is single most critical factor in sensory recovery after nerve repair, & results are adversely affected by associated
            injuries to muscle, tendon, and bone;
    - advantages:
            - include lack of scarring;
            - minimal dissection because the nerve ends have not retracted and become inbedded in scar;
            - one less operative procedure being required;
            - facilitation of recovery of motor functionn by early repair;
            - w/ long delays, there is more shrinkage of the distal nerve segment, and there is more atrophy of end organs;
    - indications for delayed repair:
            - nerve division by a blunt instrument that inflicts more tissue damage than is readily apparent, such as the case with GSW;
            - avulsion injuries;
            - grossly contaminated injuries



The time factor in surgery of upper extremity peripheral nerve injury.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, May 22, 2012 2:36 pm