Peripheral nerve injury is a common condition that spans carpal tunnel syndrome, nerve compression, iatrogenic injury due to a surgical procedure, high energy injuries from motor vehicle accidents, gunshot wounds, birth palsy (injury of the upper extremity occurring during the birth process), and Bell’s palsy (among other causes of facial paralysis).
Froedtert & the Medical College of Wisconsin plastic and reconstructive surgeons treat the range of peripheral nerve injuries with advanced microsurgery options.
“The old adage of “watch and wait” is being replaced by approaches we can take to improve outcomes,” said Patrick Hettinger, MD, plastic and reconstructive surgeon and MCW faculty member. “Within the last 10 years, nerve transfer operations have become the standard of care, with results improved over watch and wait and nerve grafts.”
The Case for Nerve Transfer
Nerve transfer “borrows” a healthy, redundant nerve and reroutes it to the injured nerve. The connection allows fibers from the donor nerve to grow into the damaged nerve and heal, restoring muscle function. Typical applications include vehicle or motorcycle injuries, Bell’s palsy and other facial paralysis, iatrogenic injury from surgical procedures.
In treating peripheral nerve injury, time is critical. “If we wait, many times these injuries don’t recover,” Dr. Hettinger said. “With motor function specifically, any muscle in the body has to be reinnervated within one year or we lose that opportunity. The existing muscle essentially becomes scar tissue.”
Treating an Underserved Group
Surgeons are also applying their expertise in microsurgery to meet the needs of a sometimes overlooked population — amputees.
“Neuropathic (phantom) pain is very common with amputees,” Dr. Hettinger said. “It can improve on its own, but many of us are being more proactive in performing targeted muscle reinnervation, right at the time of amputation. It can also be done shortly thereafter and improves the overall outcome.”
The microsurgery team welcomes referrals from any providers or health systems.
“We want to make community physicians aware of what is available in the academic medicine setting,” Dr. Hettinger said. “The old ways of waiting and watching are a thing of the past because advanced options that improve outcomes are available.”
For Our Referring Physicians:
Academic Advantage of Cosmetic and Plastic Services, Plastic and Reconstructive Surgery Services
The Froedtert & MCW health network gives patients and their referring physicians a distinct advantage.
Contact our physician liaison team for more information about our Cosmetic and Plastic Services, Plastic and Reconstructive Surgery Program or if you would be interested in meeting with any of the Cosmetic and Plastic Services, Plastic and Reconstructive Surgery Program members.