Surgical management of nerve injuries of the upper extremity in children: a 15-year survey.

Abstract

In a 15-year retrospective study, the results of 37 surgically treated nerve lesions of the upper extremity in 33 children were reviewed after a mean follow-up of 2 years. Children ranged in age from 4 to 15 years. There were 19 ulnar, 12 median, and 6 radial nerve injuries. Discontinuity of the nerve trunk was found in 23 patients operated by interfascicular grafting (18 patients) or epineural suture (5 patients). The other 14 lesions were treated by decompressive external neurolysis. Useful sensory function (S4-S3) assessed at the autonomous zone was restored in 31 patients (84%). Satisfactory motor recovery was achieved in 25 patients (67%). Independent of the type of lesion, the median nerve showed the best ability to regain complete motor and sensory function. In lesions with continuity of the nerve trunk, those affecting the radial nerve had a worse prognosis regarding motor function recovery. Unfavorable prognosis was mainly related to a time interval of more than 1 year between nerve damage and surgery.