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Adult Peripheral Nerve Disorders: Nerve Entrapment, Repair, Transfer, and Brachial Plexus Disorders

Fox, Ida K. M.D.; Mackinnon, Susan E. M.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e31820cf556
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Abstract

Learning Objectives: After reading this article, the participant should be able to: 1. Describe the pathophysiologic bases for nerve injury and how they apply to patient evaluation and management. 2. Recognize the wide variety of injury patterns and associated patient complaints and physical findings associated with peripheral nerve pathology. 3. Evaluate and recommend further tests to aid in defining the diagnosis. 4. Specify treatment options and potential risks and benefits.

Summary: Peripheral nerve disorders comprise a gamut of problems, ranging from entrapment neuropathy to direct open traumatic injury and closed brachial plexus injury. The pathophysiology of injury defines the patient's symptoms, examination findings, and treatment options and is critical to accurate diagnosis and treatment. The goals of treatment include management of the often associated pain and improvement of sensory and motor function. Understanding peripheral nerve anatomy is critical to adopting novel nerve transfer procedures, which may provide superior options for a variety of injury patterns.

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Author Information

St. Louis, Mo.

From the Division of Plastic Surgery, Washington University School of Medicine.

Received for publication January 19, 2010; accepted September 17, 2010.

Disclosure: Dr. Fox receives research funding from the Henry M. Jackson Foundation for the Advancement of Military Medicine: Development of Comprehensive Resource for the Management of Peripheral Nerve Trauma. She has no financial interests to disclose. Dr. Mackinnon receives research funding from the National Institutes of Health (NIH-CNNT 2006-2011, 1R01 NS 051706-01A2, The Effects of GDNF on Peripheral Nerve Regeneration; and NIH-ZRG1 NeuB-2, 2007-2011, 5R01 NS 033406-12, Nerve Allotransplantation for Traumatic Nerve Injury) and royalties from Synovis.

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Ida K. Fox, M.D.; Division of Plastic Surgery; Washington University School of Medicine; Box 8238; 660 South Euclid Avenue; St. Louis, Mo. 63110-1010; foxi@wudosis.wustl.edu

©2011American Society of Plastic Surgeons