Introduction
When a nerve is divided by an injury, the nerve fibres from than point down will degenerate. Repairing the nerve can still restore function by providing a path along which the nerve can regenerate.
Indications
Nerve injury is indicated in any sharply divided nerve from a penetrating injury where there is loss of nerve function.
Preoperative Instructions
Nerve repair is usually performed soon after the injury with an emergency admission to hospital. If there has been some delay, you may be admitted as an elective day surgery patient.
Procedure
Both ends of the nerve need to be visualized fully, so the wound needs to be made a bit larger, or the original scar reopened and extended. In the fingers this usually means a zigzag incision to avoid scar contracture. The nerve ends are cleaned up and repaired under an operating microscope with fine sutures and the skin is closed and a plaster splint placed to immobilise the hand.
Postoperative Instructions
Nerve injuries are usually only immobilized for 2 weeks after which exercises start with a hand therapist to maintain range of movement and recover after the stiffness caused by the surgery.
Risks
Occasionally nerve repairs can fail, resulting in no recovery of the lost nerve function, and possible the development of a neuroma.
Treatment Alternatives
Nerve injuries rarely recover without repair, so patients are strongly encouraged to have the surgery unless there are pressing reasons not to.