Nerve injuries of the hand and nerve palsies
Definition
Nerve injuries of the hand and nerve palsies are disconnections between the brain and the hand, where they are not able to communicate with each other properly.
A patient can experience a loss of sensation and/or function in the:
- Upper arm (upper extremity)
- Forearm (lower extremity)
- Hand
A nerve injury or nerve palsy could damage the ability to move your hand and arm. This leads to decreased muscle tone in the upper arm, forearm and hand.
Alternative names
Carpal tunnel syndrome; Hand nerve compression syndromes; Cubital tunnel syndrome, Radial tunnel syndrome.
Description
After getting diagnosed with a nerve injury or nerve palsy, a plastic surgeon will repair the ends of the cute nerve by sewing them together.
There are also procedures termed nerve transfers and nerve grafts. Nerve transfers are when a surgeon uses a nerve from another part of your body to repair the defect in the cut nerve. Nerve transfers are when an extra nerve is use to restore function to a damaged nerve.
However, if the nerve is very badly damaged, this can result in a permanent loss of sensation or feeling, making complete recovery almost impossible for some damaged nerves.
Risks
When it comes to nerve injury and palsy repairs, there is a risk of no recovery. Nerve surgery is associated with significant risk of failure, which could be due to various factors such as the time from injury, severity of injury, older age and smoking.
Why the procedure is performed
Nerve injury or palsy repair surgeries are performed to restore the function and sensation that a patient could have partially or completely lost due to the nerve damage. Having an early diagnosis can prevent complications and permanent damage to the nerve.
Before the procedure
A surgical treatment can be used for a hand injury or hand surgery, radial nerve injury, radial nerve palsy treatment, damaged nerve fibers or any damaged sensory nerves.
- End-to-end closure
- Nerve transfer
- Nerve graft
- Vascularized nerve graft
These four plastic surgery procedures are usually done with general anesthesia. A surgical treatment can be used for a hand injury or hand surgery, radial nerve injury, radial nerve palsy treatment, damaged nerve fibers or any damaged sensory nerves.
After the procedure
After the procedure, you can expect your hand to be in a protective splint through the duration of your nerve recovery process. There is a high chance you may experience mild swelling, pain or numbness, and sensory and motor deficits will be some of the post-operative symptoms you might experience. Seek a medical professional if symptoms worsen.
Outlook (prognosis)
The results for a nerve injury or palsy treatment can take 2 years or longer to recover. Starting physiotherapy to restore movement in your hand may be recommended by your surgeon for a better outcome.
Reference
Raut S, Johnson R, Acute nerve injuries in the hand: common patterns and treatment strategies, Orthopaedics and Trauma, Volume 37, Issue 2, 2023, Pages 111-117, ISSN 1877-1327,
Razavi CR, Eytan DF, Loyo M, Nerve repair and cable grafting in acute facial nerve injury, Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 33, Issue 1, 2022, Pages 12-19, ISSN 1043-1810,
Stepan JG, Ballistic Nerve Injuries: State of the Evidence and Approach to the Patient Based on Experience, Journal of Hand Surgery Global Online, 2024, ISSN 2589-5141,