The nerves are the wiring system that transmits electrical impulses from the brain and spinal cord to the fingertips. Each nerve is similar to a telephone or electrical cable, made up of bundles of nerve fibers - each with an outer layer of tissue called myelin that protects the nerve bundle. Nerves can be motor or sensory. Motor nerves travel from the spinal cord to muscles for movement. Sensory nerves travel from the fingers and skin toward the spinal cord to provide sensation and feeling. Most nerves have both sensory and motor fibers.
Anything that disrupts the integrity of the nerve can cause an injury. A nerve can be cut by something like a knife or a sliver from a fractured bone. Alternatively, excessive pressure on a nerve can cause damage - such as Carpal Tunnel. Diseases like multiple sclerosis can damage the myelin covering the nerve and diseases such as diabetes can cause changes within nerves. In all cases, nerve injury can result in numbness, tingling, pain, and loss of motor function or movement.
Nerve injuries result in altered sensations (such as numbness and tingling), or problems with movement. Depending on which nerves are affected and how serious the injury is, the patient may report weakness and difficulty moving fingers, wrists or elbows - and even the inability to move at all. If a nerve injury is not treated, the nerves inside the empty myelin “sleeve” may try to re-grow but are unable to connect to the opposite end. This can result in the formation of a nerve scar, called a neuroma, which can be very painful and cause an electrical shock feeling when touched.
A nerve injury that involves stretching or pressure is treated by correcting the pressure problem, such as in Carpal tunnel syndrome. When the nerve is cut or torn, the outer sheath of the nerve must be repaired. This requires the use of an operating microscope to correctly re-connect the nerve bundles. Dr. Gordon specializes in this type of microsurgical repair. The nerve fibers can then grow down the empty nerve tubes to restore function. Sometimes, there is a large segment of nerve missing and in these situations specialized nerve conduits or nerve grafts are needed to bridge the gap by splicing into the nerve at both ends. The nerve then regenerates at about an inch a month as it grows down the nerve tube.
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