Page 63 - Read Online

Titolo et al. Plast Aesthet Res 2023;10:21 Plastic and
DOI: 10.20517/2347-9264.2022.113
Aesthetic Research

Review Open Access

The treatment of nerve defects

Paolo Titolo, Andrea Fanecco
Department of Hand Surgery, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin 10126, Italy.
Correspondence to: Dr. Paolo Titolo, Department of Hand Surgery, Azienda Ospedaliero-Universitaria Città della Salute e della
Scienza di Torino, Via Gianfranco Zuretti, 29, Turin 10126, Italy. E-mail: titolopaolo@gmail.com

How to cite this article: Titolo P, Fanecco A. The treatment of nerve defects. Plast Aesthet Res 2023;10:21.
https://dx.doi.org/10.20517/2347-9264.2022.113

Received: 30 Sep 2022 First Decision: 27 Feb 2023 Revised: 26 Apr 2023 Accepted: 7 May 2023 Published: 16 May 2023

Academic Editor: Raymund E. Horch Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Among the many challenges that the hand surgeon has to face in his daily work, nerve defects of the hand
represent one of the hardest; unsatisfactory results in their treatment may cause severe limitations for the patient’s
social and working life. Many advances have been made over the years in the treatment of such conditions, and at
the current state, surgical treatment can achieve satisfactory results. This article aims to review the current
concepts in hand innervation and nerve pathophysiology and to describe traditional and novel surgical techniques
currently employed to correct these defects.

Keywords: Peripheral nerve, nerve injury, hand surgery, microsurgery

INTRODUCTION
Amid hand injuries, peripheral nerve lesions are a common issue; among surgically treated nerve injuries,
[1]
digital nerve repair is the most frequent procedure . Various mechanisms can cause these types of lesions,
although direct mechanical trauma, possibly associated with other soft and bone tissue injuries, is the most
relevant . In 2020, a study regarding the incidence of nerve injuries after extremity trauma in the United
[2]
[3]
States showed that the hands were one of the most frequent sites of injuries ; this can be explained by the
fact that in case of injury, the hands and the arms and forearms as well are out-stretched frequently as a
protective instinct, often involving the dominant hand . Peripheral Nerve Injuries (PNIs) may result in
[4]
poor long-term clinical outcomes in cases of suboptimal sensory recovery, chronic neuropathic pain, and
[5]
impaired motor function, thus afflicting life quality . Wide variability in clinical presentation, proposed

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.parjournal.net