Abstract
Injuries to the peripheral nervous system can occur during both recreational and competitive sports. The management of sports-related peripheral nerve injuries follows our understanding and treatment of other traumatic peripheral nerve injury. Nonoperative management is warranted for patients who show improvement of function on repeat serial neurological examinations and electrodiagnostic studies. Sports-related injuries that do not show evidence of regeneration on physical examination and/or electrodiagnostic studies should be considered for surgical intervention. Knowledge of types of nerve injuries and “the rule of 3’s + 1” helps guide timing of surgery. Overall, the goal of surgical intervention following sports-related nerve injuries is to improve function and hopefully to return athletes to sport.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Krivickas LS, Wilbourn AJ. Peripheral nerve injuries in athletes: a case series of over 200 injuries. Semin Neurol. Published online 2000. https://doi.org/10.1055/s-2000-9832.
Toth C. Peripheral nerve injuries attributable to sport and recreation. Phys Med Rehabil Clin N Am. Published online 2009. https://doi.org/10.1016/j.pmr.2008.10.012.
Feinberg JH, Nadler SF, Krivickas LS. Peripheral nerve injuries in the athlete. Sport Med. Published online 1997. https://doi.org/10.2165/00007256-199724060-00004.
Daly CA, Payne SH, Seiler JG. Severe brachial plexus injuries in American football. Orthopedics. Published online 2016. https://doi.org/10.3928/01477447-20160721-03.
Kirsch M, Brown S, Smith BW, Chang KWC, Koduri S, Yang LJS. The presence and persistence of unrealistic expectations in patients undergoing nerve surgery. Neurosurgery. Published online 2020. https://doi.org/10.1093/neuros/nyz335.
Seddon HJ, Medawar PB, Smith H. Rate of regeneration of peripheral nerves in man. J Physiol. 1943;102(2):191–215.
Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951;74(4):491–516.
Stoll G, Jander S, Myers RR. Degeneration and regeneration of the peripheral nervous system: from Augustus Waller’s observations to neuroinflammation. J Peripher Nerv Syste. 2002; https://doi.org/10.1046/j.1529-8027.2002.02002.x.
Gordon T. Nerve regeneration. Understanding biology and its influence on return of function after nerve transfers. Hand Clin. 2016;32(2):103–17. https://doi.org/10.1016/j.hcl.2015.12.001.
Gupta R, Chan JP, Uong J, et al. Human motor endplate remodeling after traumatic nerve injury. J Neurosurg. Published online 2020. https://doi.org/10.3171/2020.8.jns201461.
Kline DG. Surgical repair of peripheral nerve injury. Muscle Nerve. Published online 1990. https://doi.org/10.1002/mus.880130911.
Meadows JR, Finnoff JT. Lower extremity nerve entrapments in athletes. Curr Sports Med Rep. Published online 2014. https://doi.org/10.1249/JSR.0000000000000083.
Quan D, Bird S. Nerve conduction studies and electromyography in the evaluation of peripheral nerve injuries. Univ Pa Orthop J. Published online 1999.
Wilson TJ, Kleiber GM, Nunley RM, Mackinnon SE, Spinner RJ. Distal peroneal nerve decompression after sciatic nerve injury secondary to total hip arthroplasty. J Neurosurg. Published online 2019. https://doi.org/10.3171/2017.8.JNS171260.
Safran MR. Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. Published online 2004. https://doi.org/10.1177/0363546504264582.
Safran MR. Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. Published online 2004. https://doi.org/10.1177/0363546504265193.
Perlmutter GS, Apruzzese W. Axillary nerve injuries in contact sports. Recommendations for treatment and rehabilitation. Sport Med. Published online 1998. https://doi.org/10.2165/00007256-199826050-00005.
Steinman S, Bastrom TP, Newton PO, Mubarak SJ. Beware of ulnar nerve entrapment in flexion-type supracondylar humerus fractures. J Child Orthop. Published online 2007. https://doi.org/10.1007/s11832-007-0034-4.
Bevoni R. Common peroneal nerve palsy due to hematoma at the fibular neck. J Knee Surg. Published online 2013. https://doi.org/10.1055/s-0032-1330055.
Smith BW, Sakamuri S, Spain DA, Joseph JR, Yang LJS, Wilson TJ. An update on the management of adult traumatic nerve injuries – replacing old paradigms: a review. J Trauma Acute Care Surg. Published online 2019. https://doi.org/10.1097/TA.0000000000002081.
Von Keudell AG, Weaver MJ, Appelton PT, et al. Diagnosis and treatment of acute extremity compartment syndrome. Lancet. Published online 2015. https://doi.org/10.1016/S0140-6736(15)00277-9.
Saliba S, Saliba EN, Pugh KF, Chhabra A, Diduch D. Rehabilitation considerations of a brachial plexus injury with complete avulsion of C5 and C6 nerve roots in a college football player: a case study. Sports Health. Published online 2009. https://doi.org/10.1177/1941738109343544.
Rajasekaran S, Kvinlaug K, Finnoff JT. Exertional leg pain in the athlete. PM R. Published online 2012. https://doi.org/10.1016/j.pmrj.2012.10.002.
Litwiller D V., Amrami KK, Dahm DL, et al. Chronic exertional compartment syndrome of the lower extremities: improved screening using a novel dual birdcage coil and in-scanner exercise protocol. Skeletal Radiol. Published online 2007. https://doi.org/10.1007/s00256-007-0360-0.
Lauder TD, Stuart MJ, Amrami KK, Felmlee JP. Exertional compartment syndrome and the role of magnetic resonance imaging. Am J Phys Med Rehabil. Published online 2002. https://doi.org/10.1097/00002060-200204000-00016.
Ringler MD, Litwiller D V., Felmlee JP, et al. MRI accurately detects chronic exertional compartment syndrome: a validation study. Skeletal Radiol. Published online 2013. https://doi.org/10.1007/s00256-012-1487-1.
Feinberg JH, Radecki J. Parsonage-turner syndrome. HSS J. Published online 2010. https://doi.org/10.1007/s11420-010-9176-x.
Tiel RL, Happel LT, Kline DG. Nerve action potential recording method and equipment. Neurosurgery. Published online 1996. https://doi.org/10.1097/00006123-199607000-00019.
Kim DH, Kam AC, Chandika P, Tiel RL, Kline DG. Surgical management and outcome in patients with radial nerve lesions. J Neurosurg. Published online 2001. https://doi.org/10.3171/jns.2001.95.4.0573.
Kline DG, Kim DH. Axillary nerve repair in 99 patients with 101 stretch injuries. J Neurosurg. Published online 2003. https://doi.org/10.3171/jns.2003.99.4.0630.
Kim DH, Han K, Tiel RL, Murovic JA, Kline DG. Surgical outcomes of 654 ulnar nerve lesions. J Neurosurg. Published online 2003. https://doi.org/10.3171/jns.2003.98.5.0993.
Oberlin C, Beal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994;19(2):232–7. https://doi.org/10.1016/0363-5023(94)90011-6.
Witoonchart K, Leechavengvongs S, Uerpairojkit C, Thuvasethakul P, Wongnopsuwan V. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study. J Hand Surg Am. Published online 2003. https://doi.org/10.1016/S0363-5023(03)00200-4.
Tse R, Marcus JR, Curtis CG, Dupuis A, Clarke HM. Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting. Plast Reconstr Surg. 2011;127(6):2391–6. https://doi.org/10.1097/PRS.0b013e3182131c7c.
Mackinnon SE, Novak CB. Nerve transfers. New options for reconstruction following nerve injury. Hand Clin. 1999;15(4):643–66. ix
Ray WZ, Chang J, Hawasli A, Wilson TJ, Yang L. Motor nerve transfers: a comprehensive review. Neurosurgery. 2015;78(1):1–25. https://doi.org/10.1227/NEU.0000000000001029.
Schweitzer KM, Jones CP. Tendon transfers for the drop foot. Foot Ankle Clin. Published online 2014. https://doi.org/10.1016/j.fcl.2013.12.002.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Smith, B.W., Jack, M.M., Spinner, R.J. (2022). Nonoperative and Operative Management of Sports-Related Peripheral Nerve Injury. In: Oppenlander, M.E. (eds) Neurosurgical Care of Athletes. Springer, Cham. https://doi.org/10.1007/978-3-030-88227-3_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-88227-3_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-88226-6
Online ISBN: 978-3-030-88227-3
eBook Packages: MedicineMedicine (R0)