ANALYSIS OF UPPER AND LOWER-EXTREMITY PERIPHERAL-NERVE INJURIES IN A POPULATION OF PATIENTS WITH MULTIPLE INJURIES

Background: The purpose of this study was to determine the prevalence, cause, severity, and patterns of associated injuries of limb peripher al nerve injuries sustained by patients with multiple injuries seen at a regional Level 1 trauma center. Methods: Patients sustaining injuri es to the radial, median, ulnar, sciatic, femoral, peroneal, or tibial nerves were identified using a prospectively collected computerized d atabase, maintained by Sunnybrook Health Science Centre, and a detaile d chart review was undertaken. Results: From a trauma population of 5, 777 patients treated between January 1, 1986, and November 30, 1996, 1 62 patients were identified as having an injury to at least one of the peripheral nerves of interest, yielding a prevalence of 2.8%. These 1 62 patients sustained a total of 200 peripheral nerve injuries, 121 of which were in the upper extremity. The mean patient age was 34.6 year s (SEM +/- 1.1 year), and 83% of patients were male. The mean injury s everity score was 23.1 (+/- 0.90), and the mean length of hospital sta y was 28 days (+/- 1.8). Conclusions: Motor vehicles crashes predomina ted (46%) as the cause of injury. The most frequently injured nerve wa s the radial nerve (58 injuries), and in the lower limb, the peroneal nerve was most commonly injured (39 injuries). Diagnosis of a peripher al nerve injury was made within 4 days of admission to Sunnybrook Heal th Science Centre in 78% of the cases. Surgery was required to treat 5 4% of patients. Head injuries were the most common associated injury, occurring in 60% of patients. Other common associated injuries include d fractures and dislocations. The present report aims to aid in identi fication and treatment of peripheral nerve injuries.