S30. Immediate or retarded nerve repair

Abstract

We presented two cases with complete ulnar nerve section at the very same level, antebrachial region, below branches to flexor digitorum profundus, one with immediate repair and the other with delay repair of about three months. The delay repair and the immediate repair nerves were at the same month, we make them an EMG at eight weeks from repair and every four weeks until reinnervation took place (motor units seen at abductor digiti minimi). Also echography was done to ensure cubital growing. Age was similar for boths patients, gender: one man (delay) other woman (immediate). Rehabilitation techniques were the same for all of them. Also de the surgeon was the same in all two. Time for reinnervation at the immediate repair was at nine months after the epineural end-to-end repair. Time for reinnervation at the delay repair was five months after a sural nerve graft was used ( eight months after ulnar lesion). Of the two patients the delay repair has had better reinnervation (force 3/5) while the immediate repair ended with 2/5 force and also an ulnar neuroma was seen and removed, months after the nerve reached abductor digiti minimi. As we observed in these particular cases, time is more or less the same in both cases regardless of the technique to repair nerve, probably first is the inflammation phase plus wallerian degeneration, so useful reinervation takes place later, so probably delay repair is not as usefulness as it has been proposed, if it is doing in the right time, after inflammation phase has ended probably avoiding neuroma formation and less endoneural fibrosis, and also we need to search for others ways to avoid inflammation after nerve section to elevate prognosis.