Andrew Clerk
Ayr University Hospital, UK
Title: A series of nerve repairs on traumatic nerve injuries
Biography
Biography: Andrew Clerk
Abstract
Nerve injuries are a difficult surgical problem to tackle with. They have been accepted as a entity with poor prognosis. We share our experience of surgical repair of nerve injuries in three different hospitals of South Asia and Western Europe. The objectives of this retrospective study was to audit the results of nerve repairs done within a period of 10 years in three different centres of the world and assess the outcome. A retrospective analysis of the nerve repairs of the upper limb as well as of the lower limb of 456 patients were under taken in this study. The study period was 10 years from January 2003 to October 2013 and involved nerve repairs done in three institutions. Case notes of nerve repairs identified from theatre registers were used to gain information of the relevant patients. Pre-operative assessment notes and operative notes were used to identify the nerves involved, the mechanism of injury and operative interventions undertaken. Follow-up details were obtained also from the records in the case notes of the patients. A total of 456 patients were looked at in three different hospitals in Colombo, Manchester and Ayr. Out of the 456 patients 382 were males and nearly 68% were due to violence. About 12% were due to domestic accidents and 20% were occupational injuries. Out of the nerve injuries 76% were involving the upper limb and a total of 79% were associated with fractures. Three hundred and twenty one patients had primary nerve repairs. Out of the patients who had primary nerve repairs nearly 62% achieved a good functional out come. Of the group of patients who had delayed nerve repairs due to various reasons only 23% achieved a good functional out come. Common causes for nerve injuries are related to violence and occupational hazards. They are more common in the upper limb. Nerve injuries are best dealt with in the primary wound exploration where ever possible for best functional out come. Delayed exploration and repair is not entirely without a good functional result.