Nerve Repair Surgery

Renowned consultant for complex hand and wrist surgery at leading London teaching hospital, Guys and St Thomas'. Matthew James is Program director of the advanced hand surgery course.

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There are three basic symtoms of injury to a nerve:

  • Loss or alteration of sensation.
  • Loss of muscle power which may result in weakness of grip or a feeling of clumsiness.
  • Pain. This is variable in its intensity. In a chronic nerve injury the pain can occasionally be intense. A lot of people notice sensitivity to the cold. Less often gentle touching or stroking of the skin in the affected area may produce an unpleasant feeling.

If there is a wound and there are signs of a nerve injury then an operation will be necessary to look at the nerve and if there it has been partly or completely cut.

If there is no wound then it is likely that a “wait & see” policy will be adopted. Under these circumstances further investigations may be carried out to try and assess the damage to the nerve. This is done using neurophysiology testing where the nerves are stimulated with an electric current and the speed at which the nerve conducts is measured. In addition very fine needles may be inserted into an affected muscle and recordings made of the activity in that muscle. This information can help to decide what level of damage there has been to the nerve which can help in planning further treatment and giving information on the potential outcome of the injury.


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