Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience
Abstract Background Peripheral nerve injuries are severe conditions with potential lifelong impairment, which is especially meaningful for the pediatric population. Knowledge on prevalence, injury mechanisms and concomitant injuries is, therefore, of utmost importance to increase clinician awareness...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01082-x |
| _version_ | 1797865201413914624 |
|---|---|
| author | Martin Aman Kim S. Zimmermann Arne H. Boecker Mirjam Thielen Florian Falkner Simeon Daeschler Annette Stolle Ulrich Kneser Leila Harhaus |
| author_facet | Martin Aman Kim S. Zimmermann Arne H. Boecker Mirjam Thielen Florian Falkner Simeon Daeschler Annette Stolle Ulrich Kneser Leila Harhaus |
| author_sort | Martin Aman |
| collection | DOAJ |
| description | Abstract Background Peripheral nerve injuries are severe conditions with potential lifelong impairment, which is especially meaningful for the pediatric population. Knowledge on prevalence, injury mechanisms and concomitant injuries is, therefore, of utmost importance to increase clinician awareness and enable early diagnosis and treatment. As current literature on pediatric nerve lesions and concomitant injuries is scarce, we aimed to analyze all details of our patient population. Methods A total of 110 667 patients treated at our level 1 trauma center from 2012 to 2021 were evaluated for pediatric peripheral nerve injuries, causes, concomitant injuries and assessed for lesion classification (in continuity, partial lesion, dissection) and further relevant intraoperative findings. Results We found 5026 patients of all ages with peripheral nerve lesions, whereof 288 were pediatric, resulting in a prevalence of 5.7% of pediatric patients with nerve injuries. Mean age was 12.4 ± 4.6 years. Most common lesions were digital nerves (48.2%), followed by median (14.9%), ulnar (14.6%), radial (8.8%), peroneal nerve (5.2%) and brachial plexus injuries (2.1%). Of all pediatric nerve injuries, 3.8% were iatrogenic, only 30.2% had preserved continuity and 47.3% a concomitant vessel injury. Fractures were accompanied in 22.6%. Discussion We observed that a large proportion of injures had complete transections, often accompanied by concomitant vessel injuries especially in distally located injuries, highlighting the importance of early surgical exploration. Radial, ulnar and lower extremity nerve injuries were often associated with fractures. Early surgical nerve repair is key to improve motor and sensory outcomes. Knowledge on mechanisms and concomitant injuries facilitates timely diagnosis and treatment, thereby potentially preventing lifelong impairment. |
| first_indexed | 2024-04-09T23:05:21Z |
| format | Article |
| id | doaj.art-8763d37d44ae4aac9d543dd5999b317d |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-09T23:05:21Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-8763d37d44ae4aac9d543dd5999b317d2023-03-22T10:45:58ZengBMCEuropean Journal of Medical Research2047-783X2023-03-012811710.1186/s40001-023-01082-xPeripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experienceMartin Aman0Kim S. Zimmermann1Arne H. Boecker2Mirjam Thielen3Florian Falkner4Simeon Daeschler5Annette Stolle6Ulrich Kneser7Leila Harhaus8Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of HeidelbergAbstract Background Peripheral nerve injuries are severe conditions with potential lifelong impairment, which is especially meaningful for the pediatric population. Knowledge on prevalence, injury mechanisms and concomitant injuries is, therefore, of utmost importance to increase clinician awareness and enable early diagnosis and treatment. As current literature on pediatric nerve lesions and concomitant injuries is scarce, we aimed to analyze all details of our patient population. Methods A total of 110 667 patients treated at our level 1 trauma center from 2012 to 2021 were evaluated for pediatric peripheral nerve injuries, causes, concomitant injuries and assessed for lesion classification (in continuity, partial lesion, dissection) and further relevant intraoperative findings. Results We found 5026 patients of all ages with peripheral nerve lesions, whereof 288 were pediatric, resulting in a prevalence of 5.7% of pediatric patients with nerve injuries. Mean age was 12.4 ± 4.6 years. Most common lesions were digital nerves (48.2%), followed by median (14.9%), ulnar (14.6%), radial (8.8%), peroneal nerve (5.2%) and brachial plexus injuries (2.1%). Of all pediatric nerve injuries, 3.8% were iatrogenic, only 30.2% had preserved continuity and 47.3% a concomitant vessel injury. Fractures were accompanied in 22.6%. Discussion We observed that a large proportion of injures had complete transections, often accompanied by concomitant vessel injuries especially in distally located injuries, highlighting the importance of early surgical exploration. Radial, ulnar and lower extremity nerve injuries were often associated with fractures. Early surgical nerve repair is key to improve motor and sensory outcomes. Knowledge on mechanisms and concomitant injuries facilitates timely diagnosis and treatment, thereby potentially preventing lifelong impairment.https://doi.org/10.1186/s40001-023-01082-xPeripheral nerve injuryPediatric nerve injuryTraumaEpidemiologyReconstructionNerve treatment |
| spellingShingle | Martin Aman Kim S. Zimmermann Arne H. Boecker Mirjam Thielen Florian Falkner Simeon Daeschler Annette Stolle Ulrich Kneser Leila Harhaus Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience European Journal of Medical Research Peripheral nerve injury Pediatric nerve injury Trauma Epidemiology Reconstruction Nerve treatment |
| title | Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience |
| title_full | Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience |
| title_fullStr | Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience |
| title_full_unstemmed | Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience |
| title_short | Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience |
| title_sort | peripheral nerve injuries in children prevalence mechanisms and concomitant injuries a major trauma center s experience |
| topic | Peripheral nerve injury Pediatric nerve injury Trauma Epidemiology Reconstruction Nerve treatment |
| url | https://doi.org/10.1186/s40001-023-01082-x |
| work_keys_str_mv | AT martinaman peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT kimszimmermann peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT arnehboecker peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT mirjamthielen peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT florianfalkner peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT simeondaeschler peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT annettestolle peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT ulrichkneser peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience AT leilaharhaus peripheralnerveinjuriesinchildrenprevalencemechanismsandconcomitantinjuriesamajortraumacentersexperience |