Journal
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Volume 35A, Issue 4, Pages 668-677Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2010.01.007
Keywords
Compression; entrapment; integrin; neuropathy
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Funding
- NINDS/NIH
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS049203] Funding Source: NIH RePORTER
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Clinical examination and electrodiagnostic studies remain the gold standard for diagnosis of nerve injuries. Diagnosis of chronic nerve compression (CNC) injuries can be difficult in patients with confounding factors such as diabetes. The treatment of nerve entrapment ranges from medical to surgical management, depending on the nerve involved and on the severity and duration of compression. Considerable insights have been made at the molecular level, differentiating between nerve crush injuries and CNC injuries. Although the myelin changes after CNC injury were previously thought to be a mild form of Wallerian degeneration, recent evidence points to a distinct pathophysiology involving Schwann cell mechanosensitivity. Future areas of research include Schwann cell transplantation in the treatment regimen, the correlation between demyelination and the onset of pain, and the role of Schwann cell integrins in transducing the mechanical forces involved in nerve compression injuries to Schwann cells. (J Hand Surg 2010;35A:668-677. (C) 2010 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.)
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