Long-term results after primary microsurgical repair of ulnar and median nerve injuries. A comparison of common score systems.
OBJECTIVE
The aim of this retrospective study was to analyze the long-term results of primary repair of median and ulnar nerve lesions. Clinical influence factors for nerve reconstruction were investigated. Furthermore, current score systems were inquired and evaluated on their effectiveness to illustrate the success of repair.


METHODS
Sixty-five patients with 71 lesions of the median and ulnar nerve were assessed on average 8.2 years after reconstruction. The results were classified according to the DASH (disability of arm, shoulder, and hand) Score, the Rosen's hand protocol and the Highet Scale.


RESULTS
On average the patients regained 70% of their original hand function (evaluated by Rosen Score: median nerve 2.2/for ulnar nerve 1.92 out of 3.0). Although we noticed inferior motor recovery in ulnar nerve lesions, no significant differences between the overall results of both nerves were observed. Neither accompanying artery and flexor tendon injuries nor the suture technique influenced the recovery. The age of the patient was confirmed as an important influence factor. The results of the DASH Score, Rosen Score and Highet Score correlated significantly.


CONCLUSIONS
For a sufficient outcome measurement we underline the importance of evaluation of patient's estimation of their impact on their activities of daily living. For this a combination of the functional Rosen Score and the DASH Score is suggested.
Vordemvenne
Thomas
T
Department of Trauma and Hand Surgery, University Hospital of Münster, Waldeyerstr. 1, 48149 Münster, Germany. vordemv@uni-muenster.de
Langer
Martin
M
Ochman
Sabine
S
Raschke
Michael
M
Schult
Marc
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries* / Q000601:surgery*