![]() ![]() Both sensory and motor dysfunctions are present however axonal regeneration occurs due to release of chemotactic and trophic growth factors from distal targets of peripheral nerves. Because no Wallerian degeneration occurs, recovery is often complete with recovery times ranging from hours to weeks.Īxonotmesis is a second-degree injury where axonal and myelin continuity are lost, but the connective tissue layers (basement membrane) encapsulating the neural tubes remain intact. Sensory, more than motor, problems develop distal to site of injury. Temporary conduction block occurs due to local demyelination however axonal continuity remains intact. Neurapraxia is a first-degree injury where nerve compression occurs, often due to blunt trauma to the nerve. The Seddon classification describes three degrees of nerve injury: neurapraxia, axonotmesis, and neurotmesis. Nerve Injury Classification and Management Table 1 highlights our patient's recovery process as described above.ģ.2. Complete recovery of radial nerve function was evident at 8 months (MRC grade 5/5). At 3 months from date of surgery, the fracture also appeared radiologically united. Examination at 3 months demonstrated MRC grade 3/5 finger extension and wrist extension. Full active shoulder and elbow range of movement exercises commenced 4 weeks from date of surgery. An early rehabilitation programme consisting of passive range of movement exercises and dynamic splinting was commenced under the supervision of departmental hand therapists. Examination at one week from date of surgery demonstrated some early return of sensation in the distribution of the superficial branch of the radial nerve though the dense motor deficit remained unchanged. A custom-made thermoplastic wrist extension splint was initially fitted. Postoperatively, there was no immediate improvement in radial nerve function. Radiographs demonstrating surgical fixation with a dynamic compression plate. ![]()
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