Self-Assessment: New Frontiers in Nerve Injury | Interdisciplinary Care for Peripheral Nerve Injuries-Session recording- Interdisciplinary Care for Peripheral Nerve Injuries

Video Transcription

Video Summary

This comprehensive presentation highlights the interdisciplinary approach to managing peripheral nerve injuries, emphasizing early evaluation and collaborative care among specialists. Peripheral nerve injuries, though a minority of trauma cases, significantly impact physical, psychological, and socioeconomic well-being. Early referral and assessment—preferably within weeks of injury—are critical, as timely intervention ("time is muscle") improves outcomes and reduces irreversible damage like muscle denervation.<br /><br />The team approach involves physiatrists, neurologists, plastic surgeons, neurosurgeons, rehabilitation psychologists, radiologists, and therapists coordinating care. Diagnostic modalities include electrodiagnostic studies (EMG), nerve ultrasound, and specialized MRI, each offering unique insights. Ultrasound complements electrodiagnostics by visualizing nerve continuity, fascicular structure, and neuromas, especially useful within two weeks post-injury when EMG is limited. Limitations exist, such as difficulty distinguishing injury grades or deep nerve imaging challenges.<br /><br />Focused needle EMG—sometimes ultrasound-guided—targets specific muscles to assess denervation or reinnervation, guide surgical timing, and localize functioning muscle groups, improving diagnostic accuracy and safety, particularly in complex cases and unfamiliar muscles.<br /><br />Surgical management hinges on injury severity and timing. Surgery is ideally performed within 3-6 months, with earlier intervention leading to better outcomes. Options include direct repair, nerve grafts (limited by gap length and timing), and nerve transfers that reroute functional nerves to restore lost function. Postoperative recovery is prolonged, often 12-24 months, requiring sustained therapy.<br /><br />Barriers include delays in referral, logistical and insurance challenges for combined EMG/ultrasound diagnostics, and varied access to specialized care, especially in rural settings. Interdisciplinary clinics improve coordination, reduce time to surgery, and enhance patient outcomes.<br /><br />The session underscores the importance of multidisciplinary collaboration, early and coordinated evaluation, advanced imaging and electrodiagnostic techniques, and tailored surgical interventions to optimize recovery after peripheral nerve injury.

Keywords

Peripheral nerve injuries

Interdisciplinary approach

Early evaluation

Collaborative care

Electrodiagnostic studies

Nerve ultrasound

Focused needle EMG

Surgical management

Nerve grafts

Nerve transfers

Rehabilitation therapy

Multidisciplinary clinics