[Functional results of nerve reconstruction in a thoracic limb. A multicenter study]

Abstract

Objective: To assess the functional results of nerve reconstruction with autologous interfascicular nerve grafts in a thoracic limb.

Material and methods: From January 1999 to December 2006. Complete nerve injuries of the radial, median and ulnar nerves. Follow-up was at least 12 months.

Variables: age, nerve defect length, location, interval between the injury and the treatment, mechanism, injuries, and adjunctive treatments. The procedures were performed by the authors. Nine and 10-0 sutures were used. The Medical Research Council System (MRCS) scale was used for the functional measurement. The chi2 test was applied to variables and functional results.

Results: 43 patients, 48 nerves, mean age 26.7 years; 29 males and 14 females. Nineteen injuries occurred in the ulnar nerve (39.5%), 18 in the median nerve (37.5%) and 11 in the radial nerve (23%). Five patients had injury of the median and ulnar nerves. Twenty three injuries involved the wrist (53.4%), 7 the forearm (16.2%) and 12 the arm (27.9%). The mean time elapsed between the injury and the treatment was 42.09 days. The mean size of the nerve defect was 4.4 cm. The mean followup was 17.5 months. Forty two patients had associated injuries and 37 received adjunctive treatment. Motor function: Results were good in 15 patients (31.2%), fair in 21 (43.8%), poor in 10 (20.8%) and bad in 2 (4.2%). Sensory function: Results were good in 36 nerves (75%), fair in 4 (83%), poor in 6 (12.5%) and bad in 2 (4.2%).

Discussion: The results were similar to those reported in the literature.

Conclusions: Good results were obtained in gaps < or = 5 cm, in cases without arterial injury and when the time to treatment did not exceed 40 days (p < 0.05). The age, the nerve and the site of injury were not influencing factors.