title: [LONG-TERM RESULTS OF DELAYED REPAIR OF MEDIAN NERVE INJURY].
abstract: OBJECTIVE
  To review and analyze the long-term results of delayed repair of median nerve injury.
  
  
  METHODS
  Between January 2004 and December 2008, 228 patients with median nerve injury undergoing delayed repair were followed up for more than 4 years, and the clinical data were retrospectively analyzed. There were 176 males (77.19%) and 52 females (22.81%), aged 2-71 years (median, 29 years). The main injury reason was cutting injury in 159 cases (69.74%); 203 cases had open injury (89.04%). According to the injury level, injury located at area I (upper arm) in 38 cases (16.67%), at area II (elbow and proximal forearm) in 53 cases (23.25%), at area III (anterior interosseous nerve) in 13 cases (5.70%), and at area IV (distal forearm to wrist) in 124 cases (54.39%). The delayed operations included delayed suture (50 cases, 21.93%), nerve release (149 cases, 65.35%), and nerve graft (29 cases, 12.72%).
  
  
  RESULTS
  For patients with injury at area I and area II, the results were good in 23 cases (25.27%), fair in 56 cases (61.54%), and poor in 12 cases (13.18%) according to modified Birch and Raji's median nerve grading system; there was significant difference in the results between 3 repair methods for injury at area II (χ2 = 6.228, P = 0.044), but no significant difference was found for injury at area I (χ2 = 2.241, P = 0.326). Twelve patients (13.18%) needed musculus flexor functional reconstruction. Recovery of thenar muscle was poor in all patients, but only 5 cases (5.49%) received reconstruction. Thirteen cases of nerve injury at area III had good results, regardless of the repair methods. For patients with injury at area IV, the results were excellent in 6 cases (4.84%), good in 22 cases (17.74%), fair in 72 cases (58.06%), and poor in 24 cases (19.35%) according to Birch and Raji's grading system; there was significant difference in the results between 3 repair methods (χ2 = 12.646, P = 0.002), and the result of delayed repair was better.
  
  
  CONCLUSIONS
  The results of delayed repair is poor for all median nerve injuries, especially for high level injury. The technique of repair methods vary with injury level. For some delayed median nerve injuries, early nerve transfer may be a better choice for indicative patients.
authors.forename: Honglei
authors.initials: H
authors.lastname: Yin
authors.forename: Chuanjun
authors.initials: C
authors.lastname: Yi
authors.lastname: Zhu Yin
authors.forename: Guangler
authors.initials: G
authors.lastname: Tian
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D005543:Forearm Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000601:surgery*; D016067:Nerve Transfer; D019635:Neurosurgical Procedures; D059348:Peripheral Nerve Injuries / Q000145:classification*; D010525:Peripheral Nerves; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D014945:Wound Healing; D014953:Wrist; D014955:Wrist Joint