Peripheral nerves are formed by the combination of extensions of structures called neurons. Neurons form fascicles, and fascicles form nerves. Fascicles are structures that roughly resemble cables. Endoneurium surrounds the neurons, perineurium surrounds the fascicles, and connective tissue called epineurium surrounds the nerve formed by the union of all fascicles. Nerves give branches along their course, stimulating the muscles and organs, and at the same time, they carry the sensations coming from the skin, joints, muscles, etc. to the center. Nerves; They are examined in three types: sensory nerves, motor nerves, that is, nerves that stimulate muscles, and mixed nerves, that is, nerves that contain both sensory and motor fibers.
Peripheral nerves can be injured in different ways. This injury can vary in degree, from simple stretching or pressure exposure to a full-thickness rupture. The type of injury may occur due to external trauma or sometimes unintentionally during surgical interventions.
Surgical treatment of a damaged or completely severed nerve is possible. With the introduction of microscopes, results have become better. Nerves can be treated early or late. Both treatments have their own advantages and disadvantages. In nerve repair, epineural repair, that is, repair by mutual suturing of the outermost connective tissue, or fascicular repair, that is, repair by repairing the fascicles one by one, may be preferred. In this respect, repair of nerves consisting of a single fascicle is easier. The suture materials used in nerve repair are very thin and repair is required under magnifying glasses or a microscope.
Ideally, the nerves should be repaired end-to-end and without tension. In cases where end-to-end repair is not possible, end-to-end repair can be done either by changing the direction of the nerve and lengthening the nerve relatively, or by placing nerve grafts taken from other parts of the body like a bridge and repairing with grafts.
After the repair, an average of 1 mm of improvement is achieved per day. is the speed. The younger the age, the simpler and clearer the injury, and the better the surgical technique, the faster the recovery. Smoking and heavy alcohol consumption negatively affect the results.
It is important to protect the areas with sensory loss during the recovery period. Especially not to burn care should be taken. Items that are likely to be hot should first be checked with a steady hand. Stiffening of the joints may occur due to long periods of inactivity. If necessary, physical therapy can be used.
It should not be forgotten that some loss of sensation or function may be permanent in nerve incisions.
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