Results of suture of the radial, median, and ulnar nerves after missile injury below the axilla

OBJECTIVE: To evaluate the functional outcome and return to work after suture of upper extremity nerves after low-velocity missile injury.

METHODS: Forty-one patients had suture of the radial, median, and/or ulnar nerves between the wrist and axilla, 3 to 17 weeks after low-velocity missile injury. Postoperative functional outcome was good if no supplemental techniques (permanent splints, tendon or muscle transfer, fusion) were required, fair if supplemental techniques were required to restore a functional hand, and poor if the hand was severely deformed. The follow-up period was 14 to 38 months.

RESULTS: Supplemental techniques followed the suture of 11% of radial, 45% of median, 72% of ulnar, and 100% of combined median and ulnar nerve injury. After suture +/- supplemental techniques, patients returned to work in 100% of radial, 55% of median, 57% of ulnar, and 0% of combined median and ulnar nerve injuries.

CONCLUSION: Nerve suture between the wrist and axilla and supplemental techniques achieve functional recovery in the majority of patients after missile injury with good expectations for return to work, except in combined median and ulnar nerve injuries.