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  You are at: Procedure info > Hand Surgery > Nerve injury
   
   

Nerve injury - hands

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What do nerves do?

Nerves conduct signals to and from the brain. Two of the important functions nerves have in the hand are muscle function and sensation. Nerve injuries in the arm or hand can, therefore, result in loss of movement of parts of the hand and/or loss of feeling.

 

What are the main nerves in the hand?

These are the radial, median and ulnar nerves. These nerves supply the muscles of the arm and hand, and then branch into fine nerves in the fingers. The fine branches are responsible for sensation (touch).

 

What happens if the nerves are injured?

Nerve injury usually happens as a result of a cut from a knife or glass. Broken bones can also cause damage to nerves. The results of nerve damage will depend on which nerve is damaged and where the injury is.

Injury to the nerves in the arm can lead to muscle weakness. There may also be loss of feeling to the fingers - the thumb, index and middle fingers for the median nerve, the ring and little fingers for the ulnar nerve, and the back of the thumb base for the radial nerve.

The fine nerve branches of the fingers run near the sides of the finger. If one of these nerves is cut, then there is loss of feeling on that side of the finger.

 

Can nerves be repaired?

Nerves grow in very thin tubes - when a nerve has been cut, the nerve past the cut dies away, leaving an empty tube. A cleanly cut nerve can be repaired using extremely fine stitches. The nerve grows back into the empty tube, slowly making new connections again. This is an extremely slow process and can take many months.

If the nerve has been crushed or stretched, the tube may be damaged severely. New nerve growth cannot happen into the damaged tube, and this area therefore needs to be replaced. A nerve graft may therefore be needed, whereby an 'expendable' undamaged nerve is moved into the damaged area.

Results can be variable and often the nerve function and feeling will never be quite the same again despite best efforts. Careful adherence to surgeon and physiotherapists' instructions will help improve the outcome.

 

 

What are the long-term risks of nerve injury?

  • Pain - as nerves try to regrow, fine branches can become 'lost'. These can then form a ball of nerve cells, which can be extremely tender (a neuroma). This may settle with regular massage, desensitisation therapy by physiotherapy, or even surgery, but can be a long-term problem that is difficult to resolve.

  • Hand deformity - loss of muscle function in the hand can lead to an imbalance of the hand muscles, resulting in various postures of the hand. These can sometimes be managed by tendon transfer surgery to re-establish the muscle balance.

  • Muscle weakness - even if the muscle gets its' nerve supply back, variable weakness of the affected muscle can be permanent.

  • Numbness - again, recovery can be variable even if the nerve does grow back. It is quite common to have small areas of permanent numbness, although these areas tend to shrink and 'blur' in time.

  • Hypersensitivity - when the nerve grows back, it is a brand new nerve. This needs to 'learn' how to feel again. During this time the nerve can give very strange feelings, such as interpreting hot as cold and vice-versa. Light touch may also be felt as discomfort or pain. Physiotherapy can help with desensitisation techniques.

 

 

Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer

 

 

 
 
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