Abstrakt
Injuries of the peripheral nerves are not rare. They affect 2.8% of trauma patients and result in considerable long-term disability, especially in hand trauma patients.
They are typically caused by cut or stub wounds in the forearm; lacerations or gunshots are rarer. Neurotrauma needs to be ruled out in every patient with an open limb trauma and at least a basic neurological examination needs to be performed.
In case of a suspicion of nerve injury, it is necessary to refer the patient to a specialized centre for revision with possible urgent microsurgical reconstruction. Traction injuries may occur in case of low energy trauma (lesion of peroneal nerve in the knee or radial nerve in case of humerus fracture), as well as high energy trauma (brachial plexus palsy), where the nerve trauma is a typical part of a polytrauma.
Complete recovery is infrequent and usually limited to relatively minor injuries and reflects neurapraxia and axonothmesis. Laceration of the nerve has no chance of spontaneous recovery and the discontinuity has to be repaired.
Despite good general knowledge of these injuries, the patients are often referred late for treatment. The aim of this review is to provide information about the basics of nerve anatomy and the pathophysiology of peripheral nerve injuries, as well as potential surgical interventions.