Elbow Nerve Injuries: Review of Diagnosis and Treatment

In this article doctors from the Mayo Clinic provide an in-depth review of elbow anatomy. Color photos of cadavers are used to show specific nerves, tendons, and bony landmarks. The purpose of the review is to understand, diagnose, and treat nerve injuries of the elbow.

Nerve injuries are divided into five groups from mild to severe. Most elbow nerve injuries are mild and heal in six to eight weeks. Nerve injuries in children often heal faster than in adults. Fractures with nerve trauma usually need surgery to repair. This is especially true if the nerve has been cut or divided by the jagged edge of a broken bone.

The authors provide surgeons with strategies for when and how to diagnose and treat nerve injuries. For example they suggest waiting three weeks after injury to order EMG studies. Changes in nerve function from the point of injury and below may take this long to show up fully.

The management of every stage of nerve injury is discussed in detail. Signs of recovery can help the surgeon in planning treatment. Nerves recover at a rate of about one inch each month. Sweating returns before sensation. Repairing damaged nerves too late increases the risk of a poor result.

In the final section of this article, Drs. Adams and Steinmann note that nerve damage can occur with elbow arthroscopy. The needle used to enter the joint can puncture or cut a nerve by mistake. Trauma and muscle tightness from injuries can change the anatomic landmarks. The authors discuss specific ways the surgeon can avoid these types of injuries.

References: Julie E. Adams, MD, and Scott P. Steinmann, MD. Nerve Injuries About the Elbow. In The Journal of Hand Surgery. February 2006. Vol. 31A. No. 2. Pp. 303-313.