Abstract
BackgroundNerve lesions are well known reasons for reduced functional capacity and diminished quality of life. By now only a few epidemiological studies focus on lower extremity trauma related nerve injuries. This study reveals frequency and characteristics of nerve damages in patients with leg trauma in the European context.MethodsSixty thousand four hundred twenty-two significant limb trauma cases were derived from the TraumaRegister DGU® between 2002 and 2015. The TR-DGU is a multi- centre database of severely injured patients. We compared patients with additional nerve injury to those with intact neural structures for demographic data, trauma mechanisms, concomitant injuries, treatment and outcome parameters.ResultsApproximately 1,8% of patients with injured lower extremities suffer from additional nerve trauma. These patients were younger (mean age 38,1 y) and more likely of male sex (80%) compared to the patients without nerve injury (mean age 46,7 y; 68,4% male). This study suggests the peroneal nerve to be the most frequently involved neural structure (50,9%). Patients with concomitant nerve lesions generally required a longer hospital stay and exhibited a higher rate for subsequent rehabilitation. Peripheral nerve damage was mainly a consequence of motorbike (31,2%) and car accidents (30,7%), whereas leg trauma without nerve lesion most frequently resulted from car collisions (29,6%) and falls (29,8%).ConclusionDespite of its low frequency nerve injury remains a main cause for reduced functional capacity and induces high socioeconomic expenditures due to prolonged rehabilitation and absenteeism of the mostly young trauma victims. Further research is necessary to get insight into management and long term outcome of peripheral nerve injuries.
Highlights
Nerve lesions are well known reasons for reduced functional capacity and diminished quality of life
Epidemiology and mechanisms of lower extremity nerve injury Among 60,422 patients with significant lower extremity injury we identified 1058 individuals with additional peripheral nerve injury
Further analysis with subdivision into age bands was performed for both cohorts and is given in Table 1. 86,1% of all peripheral nerve injury (PNI) patients were between 16 and 59 years old, whereas only 67,5% of the control group belonged to this category. 80% of PNI individuals were male in contrast to 68,4% in the control group
Summary
Nerve lesions are well known reasons for reduced functional capacity and diminished quality of life. This study reveals frequency and characteristics of nerve damages in patients with leg trauma in the European context. Trauma of the upper and lower extremity is often combined with additional peripheral nerve injury (PNI). In a single-center study 920 out of 5721 patients with injured extremities suffered from associated nerve lesions with the need of nerve specific surgical procedures like suture or grafting [1]. In another series PNI could be detected. The objective of this study is to clarify the frequency and characteristics of nerve trauma in a large European cohort of 60,422 leg injured patients. The provided data may guide the clinician to detect nerve lesions in trauma victims presenting with certain risk factors earlier which could eventually improve their functional outcome
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