Artikel
Paediatric Peripheral Nerve Injury: Long term Sensorimotor Recovery following Primary Surgical Repair
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Veröffentlicht: | 6. Februar 2020 |
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Objectives/Interrogation: Peripheral nerve injuries in children are uncommon and complex to manage. A low threshold for surgical exploration should be used where there is a possibility of underlying nerve injury. Due to peripheral nerve injury being uncommon in this population there is a paucity of data on long term sensorimotor and functional outcomes following surgical repair. We present an 11-year retrospective analysis of paediatric peripheral nerve repair to identify long-term functional outcomes and risk factors for suboptimal recovery.
Methods: We conducted a retrospective analysis of our centre's trauma database over an 11-year period to identify all patients under the age of 18 years presenting with peripheral nerve injury who underwent primary surgical repair, with nerve injury being confirmed intra-operatively. Electronic medical records were analysed to extract procedure type, time to surgery, mechanism of injury, past medical history, post-operative complications, post-operative sensorimotor recovery and post-operative follow up period. Descriptive statistics were applied to characterise the patient cohort. Statistical analyses were conducted to identify risk factors for suboptimal sensorimotor recovery.
Results and Conclusions: A total of 108 patients were identified over an 11-year period (2006-2018) from our dataset analysis. 13 patients were excluded due to incomplete data and 8 were lost to follow up. Of the 87 patients (61 male, 26 female) included in our study, the mean age at the time of injury was 7 years (0-16 years). Mean time to surgery from presentation was 2.2 days (0-8 days). Mechanisms of injury were predominantly lacerations with sharp objects or crush injuries. Of 87 patients with follow up data, 4 did not have sensorimotor improvement, 83 patients had either partial or complete sensorimotor recovery (95.4%). Post-operative complications were rare.
Long term sensorimotor recovery in paediatric patients with peripheral nerve injury requiring surgical repair is excellent. Post-operative complications are uncommon. Age at time of injury is inversely correlated with sensorimotor recovery, time to surgical repair is not correlated with sensorimotor recovery.