Peripheral Nerve Injury — Sunderland Classification
Seddon: neuropraxia, axonotmesis, neurotmesis; Sunderland expands to 5 degrees based on structural disruption. Degree I: conduction block; II: axonal disruption intact endoneurium; III: endoneurial disruption; IV: perineurial disruption intact epineurium; V: complete transection. Prognosis worsens with increasing degree; surgical exploration/grafting typically for IV–V. EMG/NCS guide prognosis and timing; Tinel’s progression marks regeneration (~1–3 mm/day).
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1Practised by MCQ
10What is the primary structural disruption in Sunderland Grade I nerve injury?
mcqIn Sunderland Grade II nerve injury, which structure remains intact?
mcqWhich Sunderland grade corresponds to complete transection of the nerve?
mcqWhat is the expected recovery time for a Sunderland Grade I injury?
mcqWhich type of nerve injury is characterized by misdirection of regenerating axons?
mcqWhat is the primary mechanism of recovery in Sunderland Grade II injuries?
mcqWhat is the main prognostic factor in Sunderland Grade IV injuries?
mcqWhat is the typical rate of axonal regeneration following a peripheral nerve injury?
mcqWhat is the significance of Tinel's sign in the context of peripheral nerve injury?
mcqWhich Sunderland grade is characterized by intact endoneurium but disrupted perineurium?