Description
There are three basic types of peripheral nerve injuries (PNI) commonly seen in the clinic[1].
- Stretch related– the peripheral nerves are elastic, but when a traction force is too strong injury occurs. If the Traction force is strong enough, a complete tear may occur, but most commonly the continuity is retained, resulting in injuries such as [1].
The most common of the three is stretch-related, followed by lacerations and compression[2].
Classification
There are two commonly used classification for PNI- the Seddon classification and the Sunderland classification.
Seddon classified nerve injuries into three major groups: neurapraxia,axonotmesis, and neurotmesis whereas Sunderland expanded Seddon’s classification to five degrees of peripheral nerve injury as described in the table below: [2] [3]
| Seddon | Process | Sunderland |
| Neurapraxia | Local myelin damage usually secondary to compression | First degree |
| Axonotmesis | Axon severed but endoneurium intact (optimal circumstances for regeneration) | Second degree |
| Axonotmesis | Axon discontinuity, endoneurial tube discontinuity, perineurium and fascicular arrangement preserved | Third degree |
| Axonotmesis | Loss of continuity of axons, endoneurial tubes, perineurium and fasciculi; epineurium intact | Fourth degree |
| Neurotmesis | Complete physiologic disruption of entire nerve trunk | Fifth degree |
Nerve Anatomy
For a great information source for Physiotherapy following nerve injury see Nerve Injury Rehabilitation Physiotherapy
Resources
- References
- ↑ 1.01.1 Burnett MG, Zager EL. Pathophysiology of peripheral nerve injury: a brief review. Neurosurgical focus. 2004 May;16(5):1-7.
- ↑ 2.02.1 Campbell WW. Evaluation and management of peripheral nerve injury. Clinical neurophysiology. 2008 Sep 30;119(9):1951-65.
- ↑ Lee SK, Wolfe SW. Peripheral nerve injury and repair. Journal of the American Academy of Orthopaedic Surgeons. 2000 Jul 1;8(4):243-52.
- ↑ ↑ nerve damage and regeneration
