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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 215

Median and ulnar nerve injuries; what causes different repair outcomes?


1 Department of Orthopedic Surgery, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Pediatrics, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
3 Students' Research Committee, International Islamic Azad University of Khorasgan, Isfahan, Iran
4 Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Alireza Hosseini
Department of Orthopedic Surgery, Medical School, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: Nil., Conflict of Interest: There are no conflict of interest.


DOI: 10.4103/2277-9175.166162

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Background: Peripheral nerve injuries have significant effects on patients' life quality. To make patients' therapeutic expectations more realistic, prediction of repair outcome has significant importance. Materials and Methods: Totally, 74 patients with 94 nerve injuries (44 median and 50 ulnar nerves) were evaluated and followed up for 5 years between 2008 and 2013 in two main university hospitals of Isfahan. Patients' age was 6–64 years. 24 nerves were excluded from the study and among the remaining; 53 nerves were repaired primarily and 17 nerves secondarily. 42 nerves were injured at a low-level, 17 nerves at intermediate and 11 at a high one. Medical Research Council Scale used for sensory and motor assessment. S3+and S4scores for sensory recovery and M4and M5scores for motor recovery were considered as favorable results. The follow-up time was between 8 and 24 months. Results: There was no significant difference between favorable sensory outcomes of median and ulnar nerves. The difference between favorable motor outcomes of the median nerve was higher than ulnar nerve (P = 0.03, odds ratio = 2.9). More favorable results were seen in high-level injuries repair than low ones (P = 0.035), and also cases followed more than 18 months compared to less than 12 months (P = 0.041), respectively. The favorable outcomes for patients younger than 16 were more than 40 and older, however, their difference was not significant (P = 0.059).The difference between primary and secondary repair favorable outcomes was not significant (P = 0.37). Conclusion: In patients older than 40 or injured at a high-level, there is a high possibility of repetitive operations and reconstructive measures. The necessity for long-term follow-up and careful attentions during a postoperative period should be pointed to all patients.


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