Surgical Treatment

Nerve repair with realignment of bundles.

If a wound is dirty or crushed, surgery may be delayed until the skin has healed.

If there has been some loss, leaving a space between the ends of the nerve, it may be necessary to take a piece of nerve (nerve graft) from a donor part of the body to fix the injured nerve. This may cause permanent loss of feeling in the area where the donor nerve graft was taken.

Once the insulating covering of the nerve is repaired, the nerve generally begins to heal three or four weeks after the injury. Nerves usually grow one inch every month, depending on the patient's age and other factors. With an injury to a nerve in the arm above the fingertips, it may take up to a year before feeling returns to the fingertips. The feeling of pins and needles in the fingertips is common during the recovery process. While this can be uncomfortable, it usually passes and is a sign of recovery.

Therapy

Several things can be done to keep up muscle activity and feeling while waiting for the nerve to heal.

Physical therapy will keep joints flexible. If the joints become stiff, they will not work, even after muscles begin to work again.

If a sensory nerve has been injured, care must be taken not to burn or cut fingers because there is no feeling in the affected area.

With a nerve injury, the brain may need to be "re-educated." After the nerve has recovered, sensory re-education may be needed to improve feeling to the hand or finger. This involves physician therapy and the appropriate therapy based on the nature of the injury will be recommended by the physician.

Factors that may affect results after nerve repair include age, the type of wound and nerve, and location of the injury. Although nerve injuries may create lasting problems for the patient, care by a physician and proper therapy help two out of three patients return to more normal use.