gms | German Medical Science

Objective: Lower extremity nerve injury may contribute to reduced motor skills and to a diminished quality of life. So far there is a lack of data focusing on nerve damage associated with leg trauma. This investigation analyses a large transnational European database regarding incidence and characteristics of nerve lesions in patients with leg trauma.

Methods: 60422 cases with significant extremity trauma were derived from the TraumaRegistry DGU® (TR-DGU) between 2002 and 2015. The TR-DGU is a multi-centre database of severely injured patients. We compared patients with and without additional nerve injury for demographic data, trauma mechanisms, concomitant injuries, treatment and outcome parameters.

Results: About 1,8% (95% confidence interval (= CI) 1,7%-1,9%) of patients with leg injury between 2002 and 2015 suffered from concomitant nerve trauma. These patients were generally younger (mean age 38,1 y; Standard Deviation (=SD) 17,1 y) and more likely of male sex (80%; CI 74,7%-85,5%) compared to those patients without nerve lesions (mean age 46,7 y; SD 21,8 y / 68,4% male; CI 67,7%-69,1%). Our data suggest that the peroneal nerve isthe most frequently involved neural structure of the lower extremity (50,9%; CI 46,6%-55,4%). Patients with concomitant nerve damage commonly had a longer hospital stay and required more subsequent rehabilitation. Peripheral nerve injury was mainly a consequence of motorbike (31,2%; CI 27,8%-34,9%) and car accidents (30,7%; CI 27,3%-34,3%), whereas leg trauma without nerve lesion most frequently resulted from car collisions (29,6%; CI 29,2%-30,1%) and falls (29,8%; CI 29,3%-30,2%).

Conclusion: Despite its low frequency, nerve injury remains a main cause for reduced functional capacity and induces high socioeconomic expenditures due to prolonged rehabilitation and absenteeism of the mostly young trauma victims. Further research is necessary to get insight into management and long term outcome of peripheral nerve injuries.