gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Paediatric Peripheral Nerve Injury: Long term Sensorimotor Recovery following Primary Surgical Repair

Meeting Abstract

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  • presenting/speaker Benjamin Langridge - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Michelle Griffin - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Mo Akhavani - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Peter Butler - Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1913

doi: 10.3205/19ifssh1415, urn:nbn:de:0183-19ifssh14156

Published: February 6, 2020

© 2020 Langridge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.