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Peripheral nerve surgery

In peripheral nerve surgery we treat entrapment syndromes, accident-related nerve injuries and tumours of the peripheral nerves.

Peripheral nerves are all nerves in the extremities including the nerve plexus in the arm and leg. Our clinic offers a wide range of surgical treatment of diseases of the peripheral nervous system.

Prior to surgical therapy, a precise diagnosis is made up by means of electrophysiological examination (EMG, NLG), and in some cases also by imaging diagnostics (MRI, ultrasound).

Entrapment syndromes ("nerve compression syndromes") involve chronic pressure damage to peripheral nerves at mostly pre-existing constrictions; this leads to complaints such as numbness, pain, or even paralysis.

Typical entrapment syndromes are:

  • Carpal tunnel syndrome
  • Cubital tunnel syndrome (Sulcus-ulnaris syndrome)
  • Thoracic-outlet syndrome
  • Suprascapularis Compression Syndrome
  • Loge-de Guyon syndrome
  • Meralgia paraesthetica
  • Morton's Metatarsalgia

If a conservative treatment does not lead to satisfactory results, the nerves can be relieved by surgical removal of the constriction.

Common entrapment syndromes

Carpal tunnel syndrome is the most common entrapment syndrome. It involves damage to the median nerve in the wrist tunnel. This causes complaints such as the hand falling asleep at night, pain and even paralysis of the thenar muscles. The relief of the median nerves is usually performed on an outpatient basis under local anesthesia.

In the case of the sulcus ulnaris syndrome (=cubital tunnel syndrome), the ulnar nerve is compressed in the area of the elbow, which leads to numbness in the small and ring finger, up to a weakness of the hand, which is noticeable e.g. when opening a bottle. The ulnar nerve can also be decompressed and, if necessary, relocated in an outpatient operation.

Treatment after accidents

Accidents can result in injuries to peripheral nerves, even to the severing of nerves. Depending on the type of injury (blunt trauma, sharp severing of the nerve, partial or complete loss of function), either a prompt or delayed (after 3 months) operation with nerve reconstruction or transplantation must be performed. The exact decision on the procedure is made individually and depending on the results of the clinical and electrophysiological examination.

Tumours of the peripheral nerves

The most common tumours on peripheral nerves originate from the covering structures of the nerves and are usually benign (so-called "schwannomas"). These can usually be completely removed by microsurgery with a low risk of permanent neurological deficits.

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