Ruijs median/ulnar repair meta-analysis

Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair

Ruijs AC, Jaquet JB, Kalmijn S, et al. Plastic and reconstructive surgery 2005 · PMID 16079678 · doi:10.1097/01.prs.0000172896.86594.07

Systematic review / meta-analysisPrognosisPeripheral nerveCitation checked

Question: Which patient and injury factors predict motor and sensory recovery after microsurgical repair of median and ulnar nerves?
Design: Meta-analysis of individual patient data from published series of median and ulnar nerve repairs.
Patients: Patients with median or ulnar nerve transections treated by microsurgical repair, pooled from published series.
Intervention: Microsurgical nerve repair (direct or graft)
Comparison: Recovery compared across age, nerve, level, delay and repair type
Primary outcome: Satisfactory motor and sensory recovery on MRC grading
Key result: Older age, ulnar (rather than median) nerve injury, more proximal injury and longer delay to repair were associated with worse motor recovery; age and delay also predicted sensory recovery.
Limitations: Pooled heterogeneous retrospective series with differing outcome reporting; MRC grading is crude.
Impact on practice: Supports urgent primary repair of sharp nerve divisions and informs counselling, particularly that older patients and ulnar injuries have poorer prognosis.