“Your doctor will need to determine the exact location and severity of the nerve injury. A classification system called the Sunderland Classification system divides nerve injuries into five parts. These include:
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First-degree injury: A reversible local conduction block at the site of the injury. This injury does not require surgical intervention and usually will recover within a matter hours to a few weeks.
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Second-degree injury: There is a loss of continuity of the axons or electrical wires within the nerve. If this kind of injury can be confirmed through pre-operative nerve testing, surgical intervention is usually not required.
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Third-degree injury: There is damage to the axons and their supporting structures within the nerve. In this case, recovery is variable. Intra-operative nerve conduction studies are often able to help predict outcome and need for simple cleaning of the nerve (neurolysis) or a more extensive repair with grafting.
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Fourth-degree injury: In this case, there is damage to the axons and the surrounding tissues sufficient to create scarring that prevents nerve regeneration. Intra-operative electrical testing confirms that no electrical energy can be passed along the neural pathways in this injured nerve. Surgical intervention with nerve grafting is necessary to repair the damage.
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Fifth-degree injury: These injuries are usually found in laceration or severe stretch injuries. The nerve is divided into two. The only way to repair a fifth-degree injury is through surgery.”
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