Upper and lower extremities nerve injuries--own experience in surgical treatment.

Peripheral nerve injuries are a major medical problems resulting in various degrees of disability. Timely surgical intervention is crucial for the patient. The purpose of the study was to analyze the outcomes of surgical treatment of upper and lower extremities nerves injury. 77 patients were studied based on motor and sensory Medical Research Grading Systems and electromyography examination at an average follow up of 2 years. Muscle strength and sensation were assessed in six-point scales as M0-5 and S0-5 respectively. 53 patients had upper limb nerve injuries, one had brachial plexus root avulsion and 23 had lower extremity nerve damage. After surgical treatment significant improvement according to motor and sensory grading systems (> or = M3, S2) was found in 76 cases of various nerve injuries. Better results were obtained when a sural nerve graft was used together with fascial vascularized flap that decreased level of fibrosis and scarring. It was concluded that the efficacy of the treatment is strictly dependent on an early surgical intervention, mechanism and degree of the nerve injury as well as appropriate method of surgical therapy.