The Comparison of Treatment Results of Standard Repair of Traumatic Injury of the Distal Third of the Median Nerve With the Case of Applying Laser Therapy after Repair

Introduction & Nerve injuries resulting from major or minor trauma، often cause some disabilities for the patients. Neurotmesis which is characterized with a complete anatomical rupture of the nerve is the most severe form of the injury that would not recover without reconstructive surgery. Nowadays such neural damages are improved by microsurgical procedures. Some studies have used low power lasers in nerve cell’s growth in order to improve the peripheral nerves’ rehabilitation results. In fact، low power laser can be a beneficial complement in the reformation of post surgical nerve injuries. This study’s goal is to find the effects of lasertherapy after the constructive surgery of median nerve rupture in the distal half of the forearm، and to compare the results with the standard method. This study is a case-control clinical trial of 36 patients with volar surface rupture of the distal half of forearm who had been admitted to the emergency ward of Hospital within 72 hours of trauma and in examination they had paresthesia in first، second and third fingers as a result of median nerve injury. Patients were divided into two groups. The first group included patients who had been treated with standard methods and second group includes the ones who had taken low power laser along with standard method. The two groups had gone through the surgery by the same surgeon. The second group took 10 sessions of lasertherapy every other day. Clinical Examination، myelography and nerve conduction velosity was done at the third week، third month and the sixth month and the results were compared with each other. The two-point discrimination test of the index finger had a prominent result in laser group compared to the control group and NCV and EMG findings of the motor section had a significant statistical difference. This showed preference of the laser group over the control one and this was compatible with our physical exams. First finger opposition and abduction too had improved in the laser group as compared with the control group. Accordingly، Laser therapy in our protocol، Laser therapy seems to have an effect on some of the nerve growth parameters and this is mostly on motor fibers، rather than the sensory ones.