nervetrauma

Deciding whether or not to undergo exploratory surgery on your damaged nerve may well be one of the most difficult decisions of a lifetime. In a nutshell, the pros and cons of choosing surgery soon after your injury:

Pro:
- If your nerve is torn, it can be surgically repaired
- If it’s not torn, at least you’ll have a better idea of the situation
- If you decide on a conservative approach, you may find that you wasted valuable time if surgery is needed later; or, worst case scenario, surgery may not be as successful

Con:
- If the nerve is not torn, surgery cannot do a blessed thing to help it
- Risk of infection
- Risk of damage to muscle, other nerves, tendons etc
- Painful and inconvenient
- Missing out on work and activities because of recovery time

The accepted wisdom seems to be that nerve regeneration can spontaneously occur between 3-6 months. If one waits that period of time and then undergoes surgery, the success of surgery is not usually compromised. Radial nerves especially have a high rate of spontaneous regeneration. Therefore, it makes sense to me to wait 6 months before considering surgery. I’m currently on the third month and have seen no improvement in my mobility. If I didn’t have these numbers and facts in front of me, I’d probably be feeling pretty discouraged.

Traumatic Nerve Injuries - An Overview
“The usually timing of surgery is 3 to 6 months for “uncertain” injuries. If you wait longer than one year, then the chances of recovery are minimized.”

Closed Fractures Complicated by Peripheral Nerve Injury
“Patients who fail to demonstrate signs of recovery at 6 months, either clinically or with electrodiagnostic testing, should undergo exploration to maximize the likelihood for return of function.”

Neuropathy Message Board
Some very reassuring personal anecdotes here!

Radial nerve palsy associated with fractures of the shaft of the humerus
“The overall rate of recovery was 88.1% (921 of 1045), with spontaneous recovery reaching 70.7% (411 of 581) in patients treated conservatively. There was no significant difference in the final results when comparing groups which were initially managed expectantly with those explored early, suggesting that the initial expectant treatment did not affect the extent of nerve recovery adversely and would avoid many unnecessary operations.”

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