Electrophysiological evaluation of nerve affection after trauma to the extremities

Abstract EN

Objective: Evidence of peripheral nerve injury should be sought in all wounds of extremities.

Nerve conduction studies (NCSs) and electromyography (EMG) are used to evaluate the nature of pathophysiology, and quantification of the severity of involvement, detection of the level of neurological deficit and determining prognosis.

Aim of Work: The study was conducted to correlate between clinical examination and electrophysiological studies in the diagnosis and prognosis of nerve affection.

Materials & Methods: The study was conducted on 36 cases with trauma to the extremities referred to the Rheumatology & Rehabilitation Department.

They were clinically examined and electrophysiological studies were performed for every case including motor conduction of the relevant and contralateral nerve in addition to EMG of the relevant muscles.

Results: The mean age of the patients was 30.11 + 13.23 years.

Manual workers consisted 44.44% of them.

Occupational accidents were the cause of 58.33% and other accidents were responsible for another 33.33%.

The number of nerves affected in all cases was 49 nerves.

The clinical evaluation revealed that 33.33% of cases had partial injury, while 55.56% had complete injury.

The nerves proved to be affected by electrophysiological studies in 11.11% of cases while they were considered to be clinically free.

Electrophysiologically, 80% of cases showed same nerve affection as showed clinically.

Multiple nerve affection was shown electrophysiologically in 10% of cases, while clinically they were diagnosed as single nerve affection.

The ulnar nerve was the most frequent nerve affected in the studied sample.

Evidence of reinnervation was detected in 35% of cases by electrophysiological studies, while clinically they were considered completely paralyzed.

Conclusion: In every case of extremity injury needing medicolegal evaluation, electrophysiological studies should be done beside the clinical examination to discover mild, subclinical or even unnoticed deficits of nerve affection to determine the prognosis and ascertain legal liabilities.