Techniques of Peripheral Nerve Repair

Prognostic Factors for the Surgical Management of Peripheral Nerve Lesions

“…(Haase et al 1980;Kempe 1986;Brunelli and Brunelli 1990;Harris and Tindall 1991). Judgement of choosing the repair techniques also progressed parallely with this study.…”

Traumatic injuries of peripheral nerves: a review with emphasis on surgical indication

“…Technical conditions in performing surgery is another important issue that must be taken into consideration when deciding on an early repair 14 , as an adequate surgical technique has been accepted as one of the factors that influence the final result after a nerve surgery 15 . This implies the use of microscope magnification, 9.0 or 10.0caliber sutures, and a careful manipulation of nerve structures using microsurgical instrumental 16 .…”

“…This implies the use of microscope magnification, 9.0 or 10.0caliber sutures, and a careful manipulation of nerve structures using microsurgical instrumental 16 . If there are no such conditions for surgery, the epineurium of each nerve stump should be sutured to some adjacent structure, such as a tendon or fascia, in order to avoid excessive retraction of the stumps and to facilitate its identification in a second surgical procedure 14 . Any attempt to suture the nerve beyond these conditions will result in unnecessary damage to nerve tissue, increase in local fibrosis, and worse functional results at longterm followup.…”

“…Persistent neuropathic pain besides medical treatment is another indication, and, in these cases, neurolysis, which consists in the removal of a fibrotic hypertrophic epineurium and adherent adjacent tissue to the nerve, should result in partial or total pain relief 14 . Adequate surgical management of peripheral nerve injuries requires that the surgeon, beyond knowing precisely the anatomical details of the region to be assessed, also be familiarized with microsurgical techniques and dispose of the necessary equipment to perform the surgery 14 . The basic procedure in peripheral nerve surgery is the reestablishment of nerve continuity, which can be obtained by direct coaptation between the two stumps of the ruptured nerve or by interposition of nerve grafts 21 .…”

End-to-side versus end-to-end neurorrhaphy at the peroneal nerve in rats

“…However, the proximal end of the nerve may be lost sometimes or not available. One of the solutions is to use a neighbouring nerve as donor, but this leads to a functional deficiency to the innervated structures 1 .…”