Nerve Injury

What is it?

Nerves may be injured by cutting, crushing, or stretching. Nerve injuries are often associated with other injury. For example a laceration (cut) which injures a tendon may also cut a nerve. Fractures (broken bones) may stretch nerves and injure them.

Brachial plexus injuries (injuries to the nerves as they leave the cervical spine and neck) can occur from a number of mechanisms.  They occur as a result of falls, motor vehicle accidents, crossfit type of training exercises and in sporting events.  These injuries  may require significant assessment and  intervention to optimize outcome.  We have extensive experience treating  injuries above the collar bone (supra clavicular)  and below the collar bone (infra clavicular) injuries to the brachial plexus.

What are the symptoms?

Nerve injuries cause numbness and/or weakness. Numbness may be partial or complete depending on the severity of injury. Nerves go to certain areas of the hand and arm, so numbness is in a specific area depending on which nerve is injured. Similarly, weakness depends on the specific nerve which is injured. Not all nerves provide both functions. Therefore, a nerve injury may cause only numbness or only weakness. Nerve injuries can also be painful.

How is it evaluated?

The majority of nerve injuries can be diagnosed by physical examination. An assessment of muscle strength and sensation is usually all that is required. Special testing is sometimes used but is more commonly obtained when evaluating the recovery of an injured nerve. It is common to diagnose a nerve injury and then follow recovery after treatment without any special testing.

How is it treated?

In our center we can make referral for specialized neurophysiologic testing.  Our occupational therapists have significant experience with the therapy modalities, bracing and other methods of treatment that are often  required by  patients with significant nerve injury.  While exploration and repair may be necessary, newer methods of surgical treatment such as nerve transfer may improve outcome for certain patients.  Nerve transfers are surgical procedures that use a working nerve to replace the function of a nerve that doesn’t function properly.  They require optical magnification and fine microsurgical tools to be performed properly.  These procedures can often done as an outpatient procedure and can often be associated with significant improvement in limb function.  Because the nature of these procedures is complex they often require the presence of two surgeons that have experience in the care of these difficult injuries.