Median nerve injuries profoundly affect hand function and overall quality of life (QOL) due to their central role in fine motor skills and sensory perception. Surgical intervention plays a crucial role in restoring hand function and enhancing patient well-being. This retrospective study aimed to assess functional outcomes and QOL in patients who underwent surgical treatment for isolated median nerve injuries over a two-decade period.
A total of 122 consecutive cases of isolated median nerve injuries, treated surgically between January 1st, 2001, and December 31st, were included in the study. Patients with concomitant radial or ulnar nerve injuries were excluded. Functional outcomes were evaluated using the Medical Research Council (MRC) grading scale for muscle strength, while disability-related QOL was assessed using the Disability of Arm and Shoulder (DASH) questionnaire, with a minimum follow-up period of 12 months.
The majority of patients were male, with sharp and blunt lacerations being the most common mechanisms of injury. The distal forearm was the most frequent location of injury, often accompanied by associated injuries. Surgical interventions included neurolysis, split repair, interfascicular repair, and cable nerve grafting. Most patients achieved useful functional recovery (MRC grade 3 or higher), with few instances of upper extremity disability postoperatively. However, in some cases, high DASH scores were attributed to postoperative pain, despite satisfactory muscle strength. This highlights the importance of comprehensive pain management strategies in optimizing outcomes following median nerve injury surgery. Overall, surgical treatment for isolated median nerve injuries significantly prevents disability and preserves QOL, emphasizing the need for tailored interventions and postoperative care.
