Nerves are a fiber or bundle of fibers that transmit impulses of sensation to the brain or spinal cord and then to the muscles and organs.
Nerves are fragile and can be thought of as insulated electrical cables which allow electric impulses to travel where they are needed. If either the outer layer or the inner electrical portion of the nerve is damaged, the signals will either be very weak when passed, or not passed at all. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly and a loss of feeling in the injured area.
A minor injury to the nerve, a stun or bruising called “neurapraxia”, can resolve itself, but a more serious injury requires medical attention. An “axonotmesis” nerve injury occurs when the inner nerve is damaged by being stretched or broken while the outer, insulating layer is intact. Slow recovery and some potential loss of nerve function may result.
A cut or ripping of the nerve is called “neurotmesis”. This is the most severe nerve injury. The nerve ends are separated and no recovery can occur unless surgery is performed to sew the nerve ends back together again.
In cases where there is crushing/bruising of the nerve there is often a mix of all the above levels of nerve injury.
In order to assess nerve damage, the surgeon does an extensive physical examination with a muscle function evaluation. In terms of diagnostic testing, electromyography (EMG) is often used. This measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. Nerve injuries can be associated with fractures, which are determined by use of X-rays.
Minor nerve injuries, such as a stun or bruising can resolve themselves in up to six weeks. However, extensive nerve injuries, especially the most severe that result in cut or torn nerves, require treatment. Treatment can range from immobilization (with braces or splints) for up to six weeks to allow healing in axonotmesis, to surgical for more serious injuries such as neurotmesis.
At Brooklyn Premier Orthopedics, we treat all major hand conditions, including those caused by a work related accident, vehicle or sports injury. We also treat hand and wrist condition that do not result from trauma, such as arthritis and tendon disorders.