The purpose of this article is to outline the basic approach to the management of nerve injuries in the hand, which requires a thorough understanding of the pathophysiology of peripheral nerve injury and axonal response. Therefore, the basic concepts in peripheral nerve, interfascicular topographic anatomy are reviewed, and the role of epineurium, perineurium, and endoneurium in maintaining intraneural environment is outlined. The Seddon and Sunderland systems of classifying nerve injury are compared, and how categorizing nerve injury helps determine treatment and predict prognosis is discussed. The different methods of nerve repair — epineurial, fascicular, and group fascicular repair — are reviewed. Likewise, methods of nerve grafting for management of nerve gaps are outlined. Postoperative treatment regimens of appropriate periods of immobilization, neurologic testing, and physiotherapy are also defined.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine