ABSTRACT
Evidence of peripheral nerve injury should be sought in all wounds of extremities. Nerve conduction studies [NCSs] and electromyography [EMG] are used to evaluate the nature of pathophysiology, and quantification of severity of involvement, detection of the level of neurological deficit and determining prognosis. The study was conducted to correlate between clinical examination and electrophysiological studies in diagnosis and prognosis of nerve affection. The study was conducted on 36 cases with trauma to the extremities referred to the Department of Physical Medicine. They were clinically examined and electrophysiological study was performed to every case including motor conduction of the relevant and contralateral nerves in addition to EMG of the relevant muscle. The mean age of patients was 30.11 +/- 13.23 years. 44.44% of cases were manual workers. 58.33% of the injuries were accidental, of these 33.33% were occupational accidents. The number of nerves affected in all cases was 49 nerves. The clinical evaluation revealed that 33.33% of cases had partial injury, while 55.56% had complete injury A percent of 11.11% of cases were considered to be clinically free, however the nerves were proved to be affected by electrophysiologic study. Electrophysiologically 80% of cases showed same nerve affection as showed clinically. 10% of cases showed multiple nerve affection electrophysiologically, while clinically they were diagnosed as single nerve affection. Ulnar nerve was the most frequent nerve affected in the studied sample. Evidence of reinnervation was detected in 35% of cases by electrophysiological studies, while clinically they were considered completely paralyzed. It was concluded that in every case of extremity injury requiring medicolegal evaluation, electrophysiological studies should be done beside the clinical examination to discover mild, subclinical or even unnoticed deficits of nerve affection to determine the prognosis