Pediatric Peripheral Nerve Surgery - A 40-Year Single Center Experience

Introduction: Pediatric cases involving peripheral nerve surgery are poorly studied in the literature due to their low occurrence and the small number of specialized centers that serve larger populations. This study aimed to present a 40-year single-center experience with pediatric peripheral nerve surgery.

Methods: The single-center medical records were retrospectively analyzed for patients under 18 years subjected to peripheral nerve surgery, for 40 years. The cases treated due to functional disorders were excluded from the study. The minimal follow-up was 2 years.

Results: In total, 263 cases were included in the study, with a mean age of 14. The most common etiology was traumatic (91%), caused by falls, sharp object injuries, and traffic accidents, leading to nerve avulsions, contusions, lacerations, and fracture-induced compressions. The neoplastic (5%) and idiopathic (4%) etiologies were less common. The most frequently affected were ulnar nerve (38%) and brachial plexus (26%), followed by radial (12%), median (10%), peroneal (7%) and sciatic (3%) nerves. The obstetric brachial plexus palsy occurred in 5 (1.7%) cases. Microsurgical nerve reconstruction was performed in 61% of cases, with an 87% rate of useful functional recovery. The obtained results differ when compared to the literature data concerning adult cases subjected to peripheral nerve surgery. Pediatric peripheral nerve surgery cases are rare and characterized by different etiopathogenesis, clinical presentation, and outcomes compared to the adult population. Although functional recovery is generally better than in adults, careful assessment is essential at every phase, including preoperative, operative, and postoperative management.

Conclusion : This study provides valuable insights into pediatric peripheral nerve surgery, emphasizing different presentations and better functional recovery in children compared to adults. These results have the potential to guide treatment protocols and improve outcomes through better-informed surgical planning and decision-making processes.