Ultrasonography Assessment of Repaired Median Nerve

Abstract

Background: Traumatic peripheral nerve injuries (PNIs) caused by penetrating and lacerated trauma are among the most prevalent microsurgical injuries. Post-treatment follow-up and prognosis of patients undergoing repair are often based on clinical examinations and electrodiagnostic findings. Therefore, a reliable, inexpensive, useful, and rapidly accessible diagnostic method is necessary during the patient's follow-up.Objectives: This study aimed to assess the relationship between ultrasound imaging and treatment outcomes in patients with median peripheral nerve injury.Methods: In this cohort study, 21 eligible patients with symptoms of acute median nerve injury (MNI) caused by penetrating trauma in microsurgery were studied from June 2018 to June 2019. The patients underwent ultrasonography three months after repair and were followed up for at least nine months. The outcomes of the treatment were compared with those obtained six months after ultrasonography.Results: In all studied patients, mean thicknesses of the repaired nerve on the distal and the proximal sides were 2.58±0.51 and 2.51±0.61 mm2, respectively; 12 cases (57.1%) recovered very well nine months after surgery and in nine cases (42.9%) no nerve recovery was observed based on clinical electromyography (EMG) examinations and nerve conduction velocity (NCV). The amount of neuroma formed at the repair site was lower in well-recovered patients (1.5±0.4 mm3) than those with no recovery (4.9±1.5 mm3). No re-rupture was observed at the repair site. Each group underwent two-four repairs of flexor tendons.Conclusion: Ultrasound can be used as an effective and non-invasive method for assessment of PNI and follow-up of reconstructive surgery.