Turkish Neurosurgery 2016 , Vol 26 , Num 1
The Outcomes of Late Term Surgical Treatment of Penetrating Peripheral Nerve Injuries
Yurdal GEZERCAN1, Güner MENEKŞE2, Ali İhsan ÖKTEN1, Ali ARSLAN1, Kerem Mazhar ÖZSOY3, Tuncay ATEŞ1, Mustafa ÇIKILI1, İsmail UYSAL1, Burak OLMAZ1, Aslan GÜZEL4
1Adana Numune Training and Research Hospital, Department of Neurosurgery, Adana, Turkey
2Ankara Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey
3Çukurova University, School of Medicine, Department of Neurosurgery, Adana, Turkey
4Bahçeşehir University, School of Medicine, Department of Neurosurgery, İstanbul, Turkey
DOI : 10.5137/1019-5149.JTN.14094-15.1 AIM: The aim of this retrospective study was to evaluate the follow-up results of patients who received late-term surgical treatment for peripheral nerve lesions caused by penetrating injuries.

MATERIAL and METHODS: The study included 25 patients who underwent surgery for peripheral nerve injuries in our clinic between 2007 and 2013. The patients were evaluated with respect to age, gender, etiology of the trauma, the affected nerve, clinical examinations, electrophysiological findings, surgical techniques and functional outcomes.

RESULTS: The study included 30 nerves of 25 patients (19 male, 6 female; mean age 30.1 years). The mean time between the initial injury and admission to our clinic was 11.5 months (range, 3 to 30 months). Cuts caused by glass were the most common cause of injury (68.5%). The most commonly injured nerves in our patients were the median nerve (43.4%) and ulnar nerve (26.6%). External neurolysis and decompression were performed in eleven patients, epineurotomy and internal neurolysis were performed in eight patients, epineural repair was performed in fourteen patients, fascicular repair was performed in three patients, and interfascicular anastomosis using sural nerve grafting was performed in five patients. Postoperative motor strength and electrophysiological analyses showed significant improvements. Better outcomes were obtained in cases with median nerve injuries rather than other nerve injuries. Additionally, patients undergoing external neurolysis and decompression exhibited better outcomes than those undergoing other surgical approaches.

CONCLUSION: Although surgical treatment is recommended as early as possible for peripheral nerve injuries, late-term surgical treatments may provide positive outcomes. Keywords : Nerve repair, penetrating injury, peripheral nerve injury, surgical method, trauma

Corresponding author : Guner Menekse, gunerbc@yahoo.com