Artikel
Incidence of peripheral nerve trauma in England between 2006-2016 – time to increase resources for peripheral nerve trauma of the hands and upper limb?
Suche in Medline nach
Autoren
-
Jacky Chen
- Wythenshawe Hospital, Manchester, United Kingdom
-
Ralph Murphy
- Wythenshawe Hospital, Manchester, United Kingdom
-
Adam Reid
- Wythenshawe Hospital, Manchester, United Kingdom
| Veröffentlicht: | 6. Februar 2020 |
|---|
Gliederung
Text
Objectives/Interrogation: To establish the common patterns of peripheral nerve injury in England between 2006-2016
Methods: This is a retrospective observational study using cross-sectional data collected by Hospital Episode Statistics (HES) between 2006-2016 in England. Data included all primary diagnoses coded using ICD-10 codes within the study period for all hospital attendance episodes. All peripheral nerve injury codes were included and subclassified by anatomical region, age and gender.
Results and Conclusions: A total of 65,163 peripheral nerve injuries were coded over the study period. The commonest site of injury was consistently the upper limb with a median of 94.8% over 10 years (range 93.8%-95.2%, Interquartile range 0.5%), followed by lower limb at 3.0% (2.8-2.4%, 0.3%), head and neck at 2.0% (1.5%-2.7%, 0.2%) and trunk at 0.3% (0.2-0.5%, 0.2%).
Within the upper limb peripheral nerves group the majority of injuries occurred to nerves distal to the wrist (median 84.4%, range 81.5%-86.7%, Interquartile range 1.5%) followed by nerve injuries between the wrist and elbow (8.5%, 6.9-11.3%, 1.3%) and then injuries proximal to the elbow (7.2%, 6.0-8.1%, 0.6%). Of note, finger and thumb nerve injuries represented 55.4% (52.0-61.5%, 4.2%) of all injuries of the upper limb.
Nerve injuries distal to the wrist were commoner in males (70.6%, 68.8%-71.5%, 1.3%). The commonest age range to sustain injuries were patients in their third decade (27.2%, 26.0-27.9%, 0.9%), followed by the fourth (18.9%, 18.3-19.7%, 0.8%), the fifth (17.5%, 16.9-18.2%, 0.8%), the sixth and second decade (12.2%, 11.8-13.0%, 0.3% and 12.1%, 11.8-13.1%, 0.72%). The first decade and beyond the seventh decade complete the rest of the age profiles with diminishing numbers towards the extremes of life.
Conclusion: The upper limb and hands are consistently the most common regions that sustain peripheral nerve injury. The patient group most likely to present with peripheral nerve injuries are males in their third decade with finger nerve injuries. Future research into nerve surgery and allocation of resources should take these data into account. In addition, research identifying other risk factors for injury is needed.
