The incidence and management of peripheral nerve injury in England (2005–2020)

Peripheral nerve injury (PNI) is a significant health problem that confers lifelong impact on those injured. Current interventions are purely surgical; however, outcomes remain poor. There is a lack of high-quality epidemiological data that is needed to identify populations involved, current healthc...

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Bibliographic Details
Published in:	Journal of plastic, reconstructive & aesthetic surgery Vol. 80; pp. 75 - 85
Main Authors:	Murphy, Ralph N.A., de Schoulepnikoff, Camille, Chen, Jacky H.C., Columb, Malachy O., Bedford, James, Wong, Jason K., Reid, Adam J.
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-05-2023
Subjects:	Epidemiology Humans Incidence Male National Peripheral Nerve Injuries - epidemiology Peripheral Nerve Injuries - etiology Peripheral Nerve Injuries - surgery Peripheral nerve injury Peripheral Nerves State Medicine Upper Extremity - injuries Peripheral nerve injury National Epidemiology Incidence
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Summary:	Peripheral nerve injury (PNI) is a significant health problem that confers lifelong impact on those injured. Current interventions are purely surgical; however, outcomes remain poor. There is a lack of high-quality epidemiological data that is needed to identify populations involved, current healthcare demands, and ensure resources are distributed to the greatest effect, to reduce the injury burden. Anonymized hospital episode statistical (HES) data on admitted patient care was obtained from NHS Digital for all National Health Service (NHS) patients sustaining PNI of all body regions between 2005 and 2020. Total numbers of finished consultant episodes (FCEs) or FCEs/100,000 population were used to demonstrate changes in demographic variables, anatomical locations of injury, mechanisms of injury, speciality, and main operation. There was a mean national incidence of 11.2 (95% CI 10.9, 11.6) events per 100,000 population per year. Males were at least twice as likely (p < 0.0001) to sustain a PNI. Upper limb nerves at or distal to the wrist were most commonly injured. Knife injuries increased (p < 0.0001), whereas glass injuries decreased (p < 0.0001). Plastic surgeons increasingly managed PNI (p = 0.002) as opposed to orthopaedic surgeons (p = 0.006) or neurosurgeons (p = 0.001). There was an increase in neurosynthesis (p = 0.022) and graft procedures (p < 0.0001) during the study period. PNI is a significant national healthcare problem predominantly affecting distal, upper limb nerves of men of working age. Injury prevention strategies, improved targeted funding and rehabilitation pathways are needed to reduce the injury burden and improve patient care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1748-6815 1878-0539
DOI:	10.1016/j.bjps.2023.02.017