Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

[The use of intraoperative fascicle-topographic electromyography in peripheral nerve surgery: review of the literature and clinical experience]

The intraoperative assessment of a pathological nerve segment is crucial in peripheral nerve surgery. Based on different techniques the function of a peripheral nerve is analyzed and either a neurolysis alone or a resection with subsequent nerve reconstruction is performed. Beside the morphological and histological assessment or the use of a nerve stimulator, intraoperative electrophysiology is highly useful. The aim of this diagnostic tool is the recording of objective parameters, documenting the function of peripheral nerves. Intraoperative electroneurography allows the assessment of a nerve action potential over a pathological nerve segment and has been used for decades. In contrast, additional needle electromyography is rarely used even though this technique is characterized by interesting advantages: It is very helpful for the selection of donor fascicles during neurotization surgeries and for the electrophysiological assessment of neuromata in continuity. In the present review, we discuss the value of intraoperative electromyography in the treatment of peripheral nerve trauma as well as peripheral nerve tumors.