title: Median and ulnar nerve injuries; what causes different repair outcomes?
abstract: BACKGROUND
  Peripheral nerve injuries have significant effects on patients' life quality. To make patients' therapeutic expectations more realistic, prediction of repair outcome has significant importance.
  
  
  METHODS
  Totally, 74 patients with 94 nerve injuries (44 median and 50 ulnar nerves) were evaluated and followed up for 5 years between 2008 and 2013 in two main university hospitals of Isfahan. Patients' age was 6-64 years. 24 nerves were excluded from the study and among the remaining; 53 nerves were repaired primarily and 17 nerves secondarily. 42 nerves were injured at a low-level, 17 nerves at intermediate and 11 at a high one. Medical Research Council Scale used for sensory and motor assessment. S3+ and S4 scores for sensory recovery and M4 and M5 scores for motor recovery were considered as favorable results. The follow-up time was between 8 and 24 months.
  
  
  RESULTS
  There was no significant difference between favorable sensory outcomes of median and ulnar nerves. The difference between favorable motor outcomes of the median nerve was higher than ulnar nerve (P = 0.03, odds ratio = 2.9). More favorable results were seen in high-level injuries repair than low ones (P = 0.035), and also cases followed more than 18 months compared to less than 12 months (P = 0.041), respectively. The favorable outcomes for patients younger than 16 were more than 40 and older, however, their difference was not significant (P = 0.059). The difference between primary and secondary repair favorable outcomes was not significant (P = 0.37).
  
  
  CONCLUSIONS
  In patients older than 40 or injured at a high-level, there is a high possibility of repetitive operations and reconstructive measures. The necessity for long-term follow-up and careful attentions during a postoperative period should be pointed to all patients.
authors.affiliation: Department of Orthopedic Surgery, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Nouraei
authors.affiliation: Department of Orthopedic Surgery, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Hosseini
authors.affiliation: Department of Pediatrics, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Salek
authors.affiliation: Students' Research Committee, International Islamic Azad University of Khorasgan, Isfahan, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Nouraei
authors.affiliation: Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Bina
keywords: Median nerve; out comes; peripheral nerve injuries; ulnar nerve