Beyond the Knife-Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions.

Johannes C Heinzel,Lucy F Dadun,Henrik Lauer,Jonas Kolbenschlag,Adrien Daigeler,Cosima Prahm,Michael Bressler,Jana Ritter,Natalie Winter

doi:10.3390/jpm11111200

Abstract

Peripheral nerve injuries are a common clinical problem. They not only affect the physical capabilities of the injured person due to loss of motor or sensory function but also have a significant impact on psychosocial aspects of life. The aim of this work is to review the interplay of psychosocial factors and peripheral nerve lesions. By reviewing the published literature, we identified several factors to be heavily influenced by peripheral nerve lesions. In addition to psychological factors like pain, depression, catastrophizing and stress, social factors like employment status and worker’s compensation status could be identified to be influenced by peripheral nerve lesions as well as serving as predictors of functional outcome themselves, respectively. This work sheds a light not only on the impact of peripheral nerve lesions on psychosocial aspects of life, but also on the prognostic values of these factors of functional outcome. Interdisciplinary, individualized treatment of patients is required to identify patient at risk for adverse outcomes and provide them with emotional support when adapting to their new life situation.

Highlights

Peripheral nerve injuries (PNIs) have annual incidence rates in the USA of 43.8/1,000,000 for PNIs of the upper extremities [1] and 13.3/1,000,000 of the lower extremities, respectively [2]
About 25 years ago, Noble was one of the first to publish epidemiological data concerning PNI in patients with multiple injuries seen at a regional Level 1 trauma center [11] and in recent years, large multicenter studies have contributed to our knowledge and understanding of the epidemiology of lower and upper extremity PNIs [12,13]
In this work we reviewed the current body of knowledge in regard to the interplay of psychosocial factors and peripheral nerve lesions as well as these factors’ predictive value of functional outcome following peripheral nerve injury

Summary

Introduction

Peripheral nerve injuries (PNIs) have annual incidence rates in the USA of 43.8/1,000,000 for PNIs of the upper extremities [1] and 13.3/1,000,000 of the lower extremities, respectively [2]. In addition to research efforts to deepen under understanding of the peripheral nervous systems anatomy, as well as the neurobiological and pathophysiological aspects of PNIs [9], novel treatment options and concepts are rapidly evolving in the wake of refined microsurgical techniques [10]. Representative patients’ characteristics and socioeconomic sequelae of PNIs have recently been described by Bergmeister and colleagues, approaching another important perspective of research regarding surgical treatment of peripheral nerve lesions. According to their observations in a study sample of 250 patients with 268 PNIs, acute in-patient treatment costs for upper extremity nerve damages ranged between 2650€ and 5000€ [14]. The overall incidence of PNI has decreased in recent year, treatment costs are steadily increasing [1,2]

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