TRAUMATIC INJURIES OF PERIPHERAL NERVES: II. AN ANALYSIS OF THE INCIDENCE IN 301 CONSECUTIVE CASES OF PERIPHERAL NERVE INJURIES

Abstract

Summary An analysis has been made of the incidence and distribution of the lesions occurring in 301 cases of peripheral nerve injuries. Reference should be made to the text for detailed information relating to the incidence and distribution of the lesions in individual nerves. The following significant points have emerged from this analysis: 1 In the upper limb injuries of single nerves outnumbered combined lesions by six to one. 2 Lesions in the upper limb were approximately three times as numerous as in the leg. 3 With the exception of brachial plexus lesions, gunshot lesions greatly outnumbered those due to other causes, though in the case of single lesions in the upper limb the former did not predominate to the extent that might be anticipated. 4 Gunshot lesions of the brachial plexus and those due to other causes occurred in about equal proportions, but whereas the former were three times as numerous on the right, the latter occurred twice as frequently on the left. 5 Gunshot lesions of the sciatic nerve were approximately nine times as numerous as those due to other causes, where, incidentally, the incidence was very low. 6 The percentage incidence of concomitant bone injury in the various lesions was as follows: radial, 52; median, 25; ulnar, 38; and sciatic, 37. 7 Lesions due to gunshot wounds: (a) Ulnar nerve lesions predominated. This nerve was more frequently the common factor in combined lesions than either the radial or median nerve. (b) Lesions of the radial, median and sciatic nerves occurred in about equal proportions. (c) The incidence was approximately the same on the two sides for the radial and median nerves, but was greater on the left for the ulnar, posterior interosseous and sciatic, and on the right for the brachial plexus. (d) Gunshot lesions, when totalled, occurred with equal frequency on the two sides in the upper limb, but in the leg they were twice as numerous on the left. (e) The number of radial nerve lesions, single and combined, associated with a fracture greatly exceeded that in which there was no bone injury, while the reverse obtained in the case of the median, ulnar and sciatic nerves. 8 Lesions due to other causes: (a) Lesions of the ulnar nerve were double those of the median or radial nerves, which were involved in about equal proportions. (b) In combined lesions the radial, median and ulnar nerves were involved in approximately equal proportions. (c) Lesions occurred more frequently on the right in the case of the radial, median and ulnar nerves and on the left in plexus lesions.