Sometimes a nerve is persistently tender. This is usually due to a neuroma. Wrapping a vein, fat or another substance around your nerve provides padding around the nerve and will make the area less sensitive. After a nerve is injured, sometimes painful neuromas develop in smaller nerves of your hand. They are usually in locations that are not suitable for nerve repair such as amputated fingers.
I can cut away the neuroma and bury the nerve end deep in a muscle or bone. This prevents the nerve end from being knocked and should reduce the electric shock like pain. The area that the nerve supplied will be completely numb, and this is permanent. You will be given antibiotics at the beginning of your procedure and occasionally after your operation.
Antibiotic use is carefully monitored to reduce antibiotic resistance. The signs of infection to look out for include increasing redness, swelling, pain and purulent discharge. Most wound infections will respond quickly to antibiotics. Very occasionally further surgery may be required to clean out a deeper infection. Infection can lead to delayed recovery and increased stiffness. I may ask you see an expert hand therapist to provide you with a splint and complete a personalised regime of exercises to reduce stiffness.
In tests on rats, researchers at Johns Hopkins and the University of Michigan have developed a treatment that helps spinal cord nerves regrow after injury. The findings will be published in the July 18 issue of the Proceedings of the National Academy of Sciences. The study has implications for treating people who may face amputation of an arm after a violent injury in which nerves are wrenched from the spinal cord.
The new treatment currently is under study for other types of traumatic spinal cord injury. The researchers treated experimental nerve injuries in rats with an enzyme - called sialidase - that they isolated from bacteria. Four weeks later, more than twice as many nerves in the spinal cords of sialidase-treated rats grew new nerve fibers compared to untreated rats. The experimental injury in rats mimicked an injury in humans that may occur during childbirth or in motorcycle accidents when an arm is pulled violently away from the body.
This injury causes nerves to be yanked out of the spinal cord. Without these nerves, the arm loses feeling and muscle tone.
Without muscle tone, the body cannot support the weight of the arm, and many health problems can develop. While surgeons can sometimes reattach the yanked nerves to the spinal cord, this treatment is not as effective as physicians or patients would like.
This is in part because nerves in the brain and spinal cord, unlike those in the rest of the body, fail to grow new nerve fibers. Email: MGHplasticsurgery partners. Parking is available in the Parkman St. Nerve injuries are most common in the upper hand and arm and lower leg extremities. These can be caused by either blunt trauma, such as an impact from a fall or from traction injuries from motor vehicle accidents, or sharp trauma, such as occurs from a direct cut from a knife.
In either case, significant nerve injuries require expert evaluation and treatment. In some cases, where the nerve remains partly intact, careful observation and time may be all that is required to achieve recovery. However, in many instances, these injuries will require surgical reconstruction. Once the severity of injury is determined, the next step will be either continued observation or evaluation with nerve conduction studies and electromyography EMG.
These studies will be performed by a neurologist to evaluate the electrical function of the nerves and muscles and to determine the location and the extent of the injury. In some cases, MRI may be used to directly image the nerve as well.
Serial electrical studies may be performed at bimonthly intervals to look for signs of early recovery. Pressure and stretching injuries do not physically sever the nerve, but can still impede their communication with the brain.
Cutting injuries are tricky, because there can be various outcomes. Because the nerve lies within a protective canal, if the nerve is cut or broken, while the canal remains intact, it is possible that the nerve fibers will grow back eventually, but if the canal is also severed, then surgical intervention is necessary to repair the damage. Should the severed nerve not be repaired, then a neuroma, or nervous scar, can develop and these can be extremely painful.
The primary symptom of nerve damage in the hand is loss of sensation, which means that heat, cold, and pain are not felt in the hand as they would be in the rest of the body, which can lead to severe injuries. Nerve damage can also cause intense sensation and pain, know as neuralgia. Muscles supplied by the injured nerve lose their electrical stimulus rendering them paralyzed.
A detailed history and clinical exam is very important to determining what has been injured. An MRI scan may be helpful in some cases, because they allow the doctor to look inside the hand and physically see the damages to the hand and verves without having to cut into it.
As mentioned before, if the sheath that covers the nerve remains intact, the ends of the nerves farthest from the brain will die, but they will eventually grow back.
In these instances, surgery is not necessary, but the healing process can be greatly helped along by therapy, which will both keep the joints and hands in optimum working condition and help reinvigorate the sensation of the hands. The muscles will be kept from atrophy through therapeutic stimulation.
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