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Peripheral Nerve Injuries

AMA Arch Surg. 1957;75(5):742. doi:10.1001/archsurg.1957.01280170052031.
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The following points are of importance in treating peripheral nerve injuries:

1. Accurate end-to-end apposition of nerve ends with particular attention to funicular alignment, in the absence of infection, without interposition of foreign matter, such as hematoma, neuroma, scar tissue, or suture material; and in most cases during a period three to six weeks following injury

2. Prolonged immobilization

3. Intensive physical therapy during the period of regeneration.

Failures in peripheral nerve repair may usually be traced to one of the following causes:

1. Wound infection

2. Poorly placed sutures which extend into the actual neurofibrils of the nerve

3. Undue tension on the suture line

4. Poor selection of suture material

5. Incompletely resected pathologic damaged areas of the nerve

6. Inadequate period of immobilization

7. Failure to carry out a vigorous rehabilitation program

8. Even in this day of surgical technique, suture of nerve to tendon in wounds


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