Peripheral nerve repairs and their results in children

Abstract

It seems that lesions of nerves in children account for 10% to 15% of the total cases seen in this, as in other, specialist units. The prognosis for recovery after repair is defined by the severity of the original injury. The authors' worst results were seen in complete lesions of the supraclavicular brachial plexus and in the untidy wounds of war, in which penetrating missiles destroyed the proximal femur and the adjacent nerves. The outcome for injuries to the lumbosacral plexus, from fractures of the pelvis or from penetrating missile injury, are as bad. The most significant variable in determining prognosis is delay. Evidently, children are at least as vulnerable to the harmfulness of this as are adults. Skillful primary repair, however, is often followed by recovery to near normal levels, even in complex cases. Adequate follow-up is essential to detect and treat progressive deformity, especially at the ankle and foot.