Nerve section requires rapid and precise surgical repair to allow nerve regeneration and sensory and/or motor recovery.
Hand nerves ensure two essential functions: sensitivity (perception of touch, temperature, pain) and motor function (control of intrinsic hand muscles). Nerve section leads to loss of function in the affected nerve territory.
After a deep wound to the hand or finger, the patient may notice:
Any deep wound with loss of sensitivity must be considered an emergency and suggests nerve section.
No. We distinguish three types of nerve injuries, of increasing severity:
Functional "stunning" of the nerve, which keeps its anatomical structure intact. Recovery is spontaneous in a few hours, days or weeks, without surgery.
The axon (conducting cable) loses its continuity but the nerve envelope persists. Recovery is possible through guided regeneration, in several months.
Complete nerve section with loss of continuity of all elements. Without surgical repair, no recovery is possible.
Note: Palsies associated with fractures recover spontaneously in more than 80% of cases in 2 months (simple neurapraxia).
Repair of a sectioned nerve requires high-precision microsurgical technique. The intervention is performed under operating microscope, with extremely fine threads and needles.
The objective is to restore nerve continuity by matching fascicles (nerve fiber bundles) as precisely as possible, to guide axon regrowth to their original targets.
Nerve regeneration is a slow and progressive process:
Sensory reeducation may be offered to retrain the brain to interpret signals from the regenerating nerve.
No, of course not. Sequelae are frequent, even after technically satisfactory repair:
Recovered sensitivity is often different from original sensitivity (dysesthesias).
Pain and cold intolerance persist in most cases, even after good recovery.
Recovery of intrinsic muscle strength is often partial.
In absence of repair or in case of chaotic nerve healing.
Any deep wound with loss of sensitivity must be considered an emergency.
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