Nerve injuries are common after trauma and can be life-altering for patients. Electrodiagnostic
studies are the gold standard for diagnosing and prognosticating nerve injuries. However,
most surgeons are not trained in the interpretation of these studies; rather, they
rely on the interpretation provided by the electrodiagnostician, who in turn is unlikely
to be trained in nerve reconstruction. This discrepancy between the interpretation
of these studies and the management of nerve injuries can lead to suboptimal surgical
planning and patient outcomes. This review aims to provide a framework for surgeons
to take a more active role in collaborating with their colleagues in electrodiagnostic
medicine in the interpretation of these studies, with an ultimate goal of improved
patient care. The basics of nerve conduction studies, electromyography, and relevant
terminology are reviewed. The relationship between the concepts of demyelination,
axon loss, Wallerian degeneration, nerve regeneration, collateral sprouting, and clinical
function are explained within the framework of the Seddon and Sunderland nerve injury
classification system. The natural evolution of each degree of nerve injury over time
is illustrated, and management strategies are suggested.
Key words
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Article info
Publication history
Published online: June 20, 2022
Accepted:
April 2,
2022
Received:
January 25,
2022
Footnotes
Drs Pripotnev, Patterson, Yee, Pet, and Mackinnon has received support from American Foundation for Surgery of the Hand educational grant (Award Number 2831) Education Grant. No benefits in any form have been received or will be received by the other author related directly or indirectly to the subject of this article.
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
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