<prompt> True regarding nerve injury is:In all cases of open wound with clinical signs of nerve injury, nerve exploration should always be done.Nerve conduction velocity is best predictor within 48 hours of injuryPositive Tinels sign indicates the accurate location of lesionTraction nerve injury should be repaired immediately  <response>: Ans. a. In all cases of open wound with clinical signs of nerve injury, nerve exploration should always be done Ref: Schwartz 9e p1532; Bailey 25e p355; Apleys 9e p274Indications of Exploration in Nerve Injuries: Apleys 9e p274Nerve was seen to be divided and needs to be repaired, i.e., open injuryIf the ty pe of injury example a knife wound or high energy injury suggest that the nerve has been divided or severely damaged.If recovery is inappropriately delayed and diagnosis is in doubt.Positive Tinels sign tells about the regeneration of the nerve does not indicates the accurate location of lesionTraction nerve injury are usually neuropraxia managed conservatively, should not be repaired immediatelyNerve InjuryNeuropraxiaAxonotemesisNeurotemesis Reversible physiological nerve conduction blockQ Seen in crutch patsy, tourniquet palsy, and Saturday night palsyQ Loss of conduction due to axonal interruptionQ but the nerve is in continuity and the neural tubes are intact Seen in closed fractures and dislocations There is complete division of nerveQ epineurium, perineurium, endoneurium and axon all lost their continuity Seen in open woundsNerve RepairA clean cut nerve is best repaired as soon as this can be done safelyQ.The higher proximal the lesion, the worse the prognosisQ.Pure motor or pure sensory nerves recover better than mixed, because there is less chances of axonal confusion.Tinels sign indicate regeneration of nerveQ.Rate of regeneration of nerve is 1 mmdayQ.Prognosis after Nerve SuturingRadial nerve bestQ Median nerve Ulnar nerve Peroneal nerve Sciatic and femoral nerve worst prognosisQ 