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A Follow-up Study of 172 Peripheral Nerve Injuries in the Upper Extremity in Civilians
Harilaos Sakellarides
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Orthopaedic and Hand Services, Massachusetts General Hospital, Boston
1962 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1962; 44:140-148 
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Abstract

One hundred and seventy-two injuries of the main nerves in the upper extremity were studied in 149 patients.

There were ninety-eight primary sutures, seventy-two secondary sutures, and thirty-five resutures.

School children accounted for 26 per cent of the cases; 60 per cent of the lesions resulted from injuries with different kinds of glass; 46.5 per cent of the nerve lesions were combined with tendon injuries; and 14.7 per cent were associated with some kind of arterial injury.

The assessment of recovery was made primarily on a neurological basis. Motor and semisory recovery were assessed separately according to the British (Highet) method.

The results of the median, ulnar, and radial nerves after primary suture, secondary suture, and resuture were analyzed with respect to the level of injury (high, intermediate, and low), delay of repair, length of nerve defect, and age of the patient. The results of two nerve grafts were also assessed.

Although there were too few cases to permit definite conclusions, the results appeared to be best in low-level lesions and in lesions of the posterior interosseous branch of the radial nerve. Repairs of the median nerve were somewhat more successful than those of the ulnar nerve.

Secondary suture gave better results than primary suture in the median and ulnar nerve. In the few radial-nerve lesions in this study, no difference in the results by the two methods was apparent. There were more failures after primary than after secomidary suture.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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