PERIPHERAL NERVE
• Primary indication: an abnormal
neurological examination that points to an unexplained problem in a major mixed
nerve
• Secondary indication: acute trauma to
an extremity
• Work-up consists of:
EMG in all cases
MRI in selected cases
When tumor is in the differential diagnosis, MRI is
done
When ischemia is in the differential diagnosis,
angiography (and/or venography) is done
• Surgery
Indications include:
Visibly divided nerve within an open wound
Loss of neurological function that has been
localized by EMG
Presence of a tumor that requires a tissue
diagnosis
• Techniques include:
Release of entrapment
Transposition
Debridement
Perineurial suture (with or without fresh
autogenous nerve graft)
Epineurial suture
Limb shortening
Tendon transfer
Tumor resection
• Postoperative care includes physical
and/or occupational therapy |