Nerve Injury Symptoms After Surgery: What to Expect

How long does it take to be aware of nerve injury?

I had a fracture in my arm that required surgery.
On the day of the injury, I only knew that my humerus was fractured (Monday), and the doctor scheduled the surgery for the day after tomorrow (Wednesday).
After the surgery, I informed the doctor that I had lost sensation in my ring and little fingers, could not straighten them, and my palm could not close.
The doctor mentioned that this might be due to the injury at the time.
I would like to ask if it is reasonable that my hand felt normal from the time of the injury until the next day, and that the symptoms only appeared after the surgery?

Mr. He, 20~29 year old female. Ask Date: 2014/03/01

Dr. Gao Chunde reply Neurology

Based on your symptoms, it appears that you have an ulnar nerve injury.
Generally, symptoms arise when a nerve is injured; however, it is also possible that the nerve itself is not initially damaged but may gradually be compressed or stretched by surrounding edema, affecting its function.
It is recommended that you consult a neurologist nearby for an on-site evaluation and answers regarding your specific condition.

Reply Date: 2014/03/01

More Info

Nerve injuries can be a complex and concerning issue following surgical procedures, particularly when they involve fractures or trauma to the bones and surrounding tissues. In your case, it appears that you experienced a loss of sensation and motor function in your ring and little fingers after undergoing surgery for a humeral fracture. This situation raises several important questions regarding the nature of nerve injuries, their symptoms, and what one can expect in terms of recovery.

Firstly, it is indeed possible for nerve symptoms to manifest after surgery, even if the sensation was normal immediately following the injury. When a fracture occurs, the surrounding tissues, including nerves, can be affected. However, symptoms may not always be apparent right away due to swelling, inflammation, or the effects of anesthesia. In some cases, the surgical procedure itself can lead to additional trauma to the nerves, either through direct manipulation or due to the formation of scar tissue post-surgery. This can result in symptoms such as numbness, tingling, weakness, or loss of function in the affected fingers.

The timeline for nerve recovery can vary significantly based on the extent of the injury and the specific nerves involved. Peripheral nerves, for instance, regenerate at a rate of approximately 1 millimeter per day, which means that recovery can take weeks to months. In your case, since the symptoms appeared post-surgery, it is crucial to monitor the situation closely. If the nerve was compressed or damaged during the surgical procedure, it may take time for the symptoms to resolve, and in some cases, additional interventions may be necessary.

In terms of management, physical therapy is often recommended to help maintain muscle strength and prevent atrophy while the nerve heals. Occupational therapy may also be beneficial, particularly in learning adaptive techniques to perform daily activities despite the temporary loss of function. If the symptoms persist or worsen, further diagnostic evaluations, such as nerve conduction studies or electromyography (EMG), may be warranted to assess the extent of nerve damage and guide treatment decisions.

Additionally, it is essential to communicate openly with your healthcare provider about your symptoms. If you notice any changes, such as increased pain, swelling, or changes in sensation, it is vital to report these to your doctor promptly. They may consider imaging studies or refer you to a specialist, such as a neurologist or orthopedic surgeon, for further evaluation and management.

In summary, while it is not uncommon for nerve symptoms to develop after surgery, especially following a fracture, it is essential to monitor these symptoms closely and engage in appropriate rehabilitation. Recovery can take time, and the involvement of healthcare professionals in your recovery process is crucial for achieving the best possible outcome. If you have any concerns or questions about your recovery, do not hesitate to reach out to your healthcare provider for guidance and support.

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