Hand & Wrist Center of Houston Home If you suspect broken bones, dislocated joints, lacerated tendons, lacerated nerves, infection, or have an open wound below the elbow, then call us immediately.
 
RECONSTRUCTION FOR NERVE DEFICIT


WHAT YOU SHOULD KNOW

Injuries to the limb that damage nerves rob patients of critical functions. Nerve damage is graded on a six-point scale with higher numbers worse. Grade I and II nerve damage cannot be helped by surgery. Higher-grade injuries may benefit from surgery. Once nerve damage exists there will always be gap of some length between the healthy nerve above and the nerve target for grafting below. Even after reconnection, nerve fibers only regrow at the speed of a millimeter per day. Muscles atrophy quickly and if new nerve fibers cannot be made to reach them by a year from injury, it is usually not worth reconstructing.

MEDICAL HISTORY

The details of the original injury and any other surgeries that have been performed are critical to planning the reconstruction. The patient should bring any reports of previous surgeries.

EXAMINATION

Each of the arm's nerve functions is specifically tested for both movement and feeling ability.

ADDITIONAL TESTS

Electrical nerve tests are valuable in confirming the findings of the physical examination and sometimes distinguishing between partial and complete nerve injuries.

TREATMENT OPTIONS

  NERVE GRAFTS NERVE TRANSFERS TENDON TRANSFERS
CONSISTS OF Splicing segments of the patient's own nerves between damaged segments Moving a working nerve from its original assignment to connect to the damaged nerve Moving a working tendon from its original assignment to one needed to make up for one of the lost movement functions
FEATURES Nerve grafts taken from the back of the leg Done close to the targets for movement and feeling to minimize time to recovery Only tendons that can afford to give up their original function are used
ADVANTAGES The original muscles are reactivated Reduces the long wait for recovery seen with nerve grafting Can be done up to almost any time after injury
DISADVANTAGES Only effective if done early, final function usually quite weak compared to normal Limited source of nerves available for transfer, the brain must learn to use the new connection Substitution with a tendon transfer can never really recreate the original lost function and the brain must learn to use the new connection

RECOVERY

Sutures are removed in the office at 2 weeks. Limited protection on movement is observed for the first several weeks after nerve grafting or nerve transfer. The first 4 weeks after tendon transfer, protective splints are used. Tendon transfer cases continue on with motion exercises to maximize tendon functions and finish with strengthening over around a 3-month process. Nerve surgery cases have a prolonged period of waiting until evidence of functional recovery first appears. At that time, the patient re-enters therapy for specific exercises that assist in developing the nerve connections to their targets.
 
 
 
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  • I was very impressed with how I was treated by the doctor as well as the Medical assistant. All my questioned were answered and I was treated with care and respect. Luis was Awesome! Doctor Henry was very informative. I will recommend him to friends and family - 06/09/17
  • The doctor and staff are the best I have ever had. Very professionalism at its best. - 11/15/17
  • an experience beyond expectation - 10/06/17
  • Dr. Henry gave me my wrist back!!! Thank you Dr. Henry!!! - 07/10/17
  • outstanding knowledge and gets you into the hospital if needed the same. - 02/09/18
  • every thing was really great - 10/19/17
  • very good team work, best clinic - 06/21/17
  • Dr. Henry and his staff are phenomenal. Dr. Henry has a gift for not only treating health issues extremely effectively, but he is extremely thorough and very efficient at communication and explaining everything he is doing and all of clearly outlining your options for future procedures. - 05/11/18
  • MD was very thorough and spent a good amount of time with the patient (me). MD had good bedside manners which you do not see from a lot of doctors nowadays. He also made sure everything was understood and that I was given a chance to ask questions or address any concerns I had. Everyone was courteous and professional. Thank you for making mu visit a pleasant one. - 05/02/18
  • Dr. Henry was able to salvage my hand to make it usable again. I have already sent my Father here and he no longer has any pain in his wrist. - 11/13/17
  • Thank you for sewing me back together and guiding me through my recovery!!! - 05/15/18
  • I am really happy with my experience. I always knew what was going on and over time got to know the staff based on how many times I've been here. Most importantly, I feel I got the right treatment for my injury. - 10/19/17
  • Very nice staff and surgeon. Thumb looks good now after surgery, hopefully thumb continues to heal and stays healed. Thank you - 01/30/18
  • very confortable,Dr. Henrry very professional and very friendly staff - 12/05/17
  • Very happy I came here for the surgery, etc. - 06/09/17
  • Great job your staff is the best,thank you &GOD Bless all of you! - 06/15/18
  • Thank you for repairing my injury and being kind in the process. - 01/10/18
  • dr henry does an excellent job of explaining the problem and solution, seems extremely competent - 02/07/18
  • you were very good, thank you very much - 05/17/18
  • thank you - 10/16/17
  • Dr. Henry and his staff are amazing! I was able to get an urgent new patient appointment immediately with surgery that same afternoon. Dr. Henry does an excellent and thorough job explaining my injury and the healing process. Very impressed with his plan of early mobility and physical therapy, which helped restore my function back to normal within 8 weeks of surgery. I would 100% recommend Dr. Henry and his staff! Very pleased and grateful for his help. - 03/23/18
  • I couldn't be more pleased with the level of service I received while in Dr. Henry's care. The level of detail in which my injury was explained and resolved, and the level of competency that was displayed throughout the healing was truly outstanding. - 01/30/18
  • no complaints hand is coming along very well - 11/06/17
  • every body was excelent - 01/09/18
  • Outstanding service and results - 10/30/17
  • best place for treatment of hand and wrist problems. Dr. Henry was recommended to me by a friend who is a medical care professional. - 10/06/17
  • Dr. Mark Henry is a true healer; the finest most competent doctor I've ever encountered. I am forever grateful to Dr. Henry and the entire staff for saving my finger and facilitating my complete recovery with grace and seriousness of intent. Thank you. - 01/10/18
  • excellent! dr & staff! - 06/14/17
  • With the severity of my injury I am amazed at how functional my wrist is with the amazing team work shown at the office. From the very start the service and care have been outstanding!! I can't thank everyone enough! - 02/23/18
  • :) - 06/01/17
  • The staff and the Dr. are very helpful and understanding .I have not yet seen a better staff like this office . I will recommend any one here . - 11/06/17
  • Great Doctor and staff. Luis is a wonderful asset to the staff - 12/18/17
  • great doctor - 05/23/18
  • The staff is nice and everyone is up on the treatment. I feel confident that I am getting the best care and am glad I came here. - 10/30/17
  • I appreciate the expertise and experience of Dr. Henry!!! I know I had the BEST hand surgeon!!! - 05/02/18
  • Dr. Henry is a tremendous doctor! - 05/22/18
  • Very efficient practice - 10/19/17
  • love the circus de sole dvd. everything was amazing. rehab was the best too. - 02/23/18
  • Dr. Henry was very informative about the treatment and staff was pleasant. - 01/11/18
  • very helpful. staff was very helpful and outstanding. Dr. Henry explained everything to me - 06/19/18
  • The staffs here was GREAT!!!! - 06/21/17
  • all excellent care - 07/12/17
  • the whole group was very good, I had an excellent experience. - 11/09/17










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