Intrinsic Reinnervation—Myth or Reality?

Abstract

A clinical and electromyographic study of major nerve transections at the wrist in 22 patients has shown that electrical recovery nearly always occurs in the intrinsic muscles, despite the absence of clinically detectable function. There appears to be a level of electrical reinnervation above which clinically detectable intrinsic muscle power is usually present. This level would appear to be 50% of the contralateral maximum evoked muscle action potential; above this the "myth" of clinical recovery becomes a reality.

Surgical management and outcome in patients with radial nerve lesions

“…During the recovery period following nerve injury, EMG studies often show reinnervation activity in the intrinsic muscles before any clinical evidence of functional recovery. 16 Following nerve repair, evidence of electrophysiological recovery appeared after 4 to 6 months, with clinical activity returning 3 to 5 weeks later. 6 After adequate external neurolysis, the use of intraoperative NAP monitoring is an integral part of surgical decision making.…”

Nerve Transfers in the Hand and Upper Extremity Surgery

“…18,19 This situation presents a distinct opportunity for reconstruction with a nerve transfer because minimizing this distance is one of its main principles. Distal motor nerve transfer can provide return of pinch strength and prevent ulnar claw formation, often without the need for tendon transfers.…”

Surgical outcomes of 654 ulnar nerve lesions

“…13 Following an operation, evidence of electrophysiological recovery can be detected within 5 to 9 months, depending on the level of the injury, whether neurolysis, end-to-end repair, or graft repair has been performed, and if the latter, depending on the length of the graft.…”