Healing capacity of the peripheral nerve is quite high. Even in completely damaged peripheral nerves, after good and timely repairs, the patient may recover to such an extent that there is no malfunction.

 

When the peripheral nerve is cut, the part of the nerve under the cut begins to melt, this is called “Wallerian Degeneration”. When the nerve is repaired, the intact part above the incision moves down to the part that has undergone Wallerian degeneration. This growth rate is approximately 1 millimeter per day. This is approximately 3 cm per month and 36 cm per year. When the healed nerve reaches the muscle, the movement starts again in the muscles. This process sometimes takes months, and therefore muscle atrophy, called atrophy, is observed.

Knowing this time factor is very important, so patients should wait patiently without losing their hope, and by doing passive exercises, they should prevent the related joint from freezing due to inactivity and ensure that the muscles remain strong without melting.

Treatment is done with microsurgical techniques, if the injury is not a gunshot wound, it should be done as soon as possible. Generally, surgical treatment is planned for patients who do not improve within 1 month. In firearm injuries, it can be expected up to 6 weeks as the bullet will have a burning and pressure effect.

 

In surgical treatment, the surgical technique is decided according to the condition of the nerve and the nerve conduction tests performed during the surgery. Only the nerve can be released, or it may be necessary to repair the nerve by suturing the nerve end-to-end or patching it with nerve grafts.

If the nerve cuts are not repaired within 1 year, motor movement in the muscles is not expected to return, and if the sensation is not repaired within 3 years, it is not expected to return.

 

Recovery after surgery cannot be said to be complete, and active physical therapy should contribute to the recovery of nerves and muscles. Physical therapy provides control of edema, pain and inflammation, protects joint movements, prevents excessive tension of the affected muscle, preserves the strength of healthy muscles, prevents muscle wasting, contributes to regaining sensation loss, protecting, maintaining or increasing functions, and education of the patient.