PERIPHERAL NERVE PALSY

Nerves function to provide mobility and sensation on the hand and upper limb. Part of the nervous system located between the cranial cavity and spinal cord is called central nervous system; and the parts from which they branch into the entire body are called peripheral nervous system. Palsy is a condition wherein peripheral nerve functions break down for any reason; hence the muscles to which the nerve or group of nerves transmits electric signals do not function any more.

Upper limb has five primary peripheral nerves. Axillar nerve, which is one of them, transmits electric signals to the deltoid, enabling the arm to open to the side. Radial nerve enables that the elbow, wrist and all of the fingers extend. Musculocutaneous nerve borrows its fibers to the biceps muscles, so the elbow is bent. Median and ulnar nerves enable touch sensation of our hand and bending movement of the wrist and fingers. Should any of the peripheral nerves cease to function and the patients become unable to do the aforecited functions.

The most common reason for the nerve palsy is cuts following a trauma. Otherwise, nerve compression, obtuse traumas that do not result in any cuts, tumors, although very rarely, a set of various neurological disorders that retain systemic or isolated nerves may appear to be influential factors.

On concluding that the nerve cannot recover on its own (which might take a couple of months), it becomes final with the help of a test called EMG that measures muscular and nervous functions. After this, a treatment is planned depending on the level of the nervous cut, age and profession of the patient and date of nervous cut. Palsy due to nervous cuts is treated in early periods by repairing it under the microscope. If a lot of time has passed, the treatment is made via tendon transplantation as irrevocable myolysis appear (Detailed information about tendon transplantations has been provided in this chapter). Physiotherapy is a compulsory and complementary part of many disorders in the field of hand surgery before and after the operation.

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