NERVES OF THE HAND
Injuries of the nerves of the palm and the fingers, do not cause wide-spread motor and sensory disturbances. They require surgical treatment in many cases when the specific motor and sensory disturbances on the palm and the fingers can impede the performance of a number of professions.
OPERATIVE TECHNIQUE
On the palm, the incisions are made along the path of its creases, and on the fingers on the lateral surface in proximity to the nerve projection (Fig. 21-42). Suturing of nerves is done under a microscope with a thin atraumatic needle and sutures of the order of 8-0 to 10-0.
Overcoming of the nerve gaps is achieved by flexing the wrist, when a suture is made in the proximal part of the palm and in flexing the fingers, when the nerves are sutured in the distal part of the palm and in the fingers themselves. In case of bigger gaps can be used grafting from the sural nerve.
After suturing the nerve in the proximal part of the palm, the restoration of rough sensation takes place in about 7 months, and if the suture is in the distal part of the palm in 3 . 4 months. In suturing the nerves of the fingers this term is shorter, depending on the level (on which phalanx) the injury is. The fine sensation in the fingers usually is restored within one year.