[Surgical treatment after lesions of the superficial branch of the radial nerve - mid-term outcomes].

Abstract

The treatment of lesions of the superficial radial nerve remains a challenge for surgeons and patients. For patients, such lesions are associated with a high level of suffering due to electrifying pain at the level of the injury as well as sensory dysfunction. Our data collected over a treatment period of 6 years are intended to give an overview of surgical methods, temporal progression and the corresponding outcomes.We retrospectively analysed 17 cases of patients undergoing surgery after a lesion of the superficial branch of the radial nerve between 4/2017 an 12/2022. Sixteen patients were surveyed using standardised measures with regard to regeneration, pain relief and post-surgical satisfaction. The average latency between the causal event and the surgical procedure was 13.4 months (3-60 M). Neurolysis was carried out in 4 of 16 cases in the presence of macroscopically visible cicatricial changes without the occurrence of morphological changes in the nerve and with preserved continuity. Reconstruction through suturing was performed in 12 cases, 4 being performed without and 8 with neuroprotection. In 2 of the latter, neuroprotection was achieved with a neurotube, while 6 were treated by means of wrapping veins.The performed interventions all led to a reduction of pain. Regardless of the time interval between the lesion of the superficial radial nerve and surgery, the procedure led to a relief from discomfort related to previous symptoms of pain, hypesthesia and Tinel sign. Although the reconstruction of the nerve did not lead to complete remission, the patients were satisfied with the results. In most cases, some hypesthesia remained. Neuroprotection through a vein graft led to better pain relief than treatment without a vein graft.Although symptoms remained, pain relief was crucial for the patients. After lesions of the superficial branch of the radial nerve, surgical treatment aiming to preserve or restore the continuity of the injured nerve branch should be considered as a promising option.