Surgical management of the divided nerve

Mapping Intimacies ◽

10.1093/med/9780199682874.003.0041 ◽

2021 ◽

pp. 269-275

Author(s):

Duncan A. McGrouther

Keyword(s):

Peripheral Nerve ◽

Surgical Management ◽

Nerve Repair ◽

Nerve Graft ◽

Nerve Injuries ◽

Peripheral Nerve Repair ◽

Direct Repair

This chapter describes the principles of peripheral nerve repair by direct repair or nerve graft with specific discussion of assessment, exposure, and techniques of nerve repair. Notes on specific nerve injuries, neuroma management and outcomes are included.

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Techniques of Peripheral Nerve Repair

Scandinavian Journal of Surgery ◽

10.1177/145749690809700407 ◽

2008 ◽

Vol 97 (4) ◽

pp. 310-316 ◽

Cited By ~ 64

Author(s):

L. B. Dahlin

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Correct Diagnosis ◽

Nerve Injuries ◽

Nerve Roots ◽

Postoperative Rehabilitation ◽

Cold Intolerance ◽

Peripheral Nerve Repair ◽

Nerve Grafts ◽

Nerve Transfers

Nerve injuries extend from simple nerve compression lesions to complete nerve injuries and severe lacerations of the nerve trunks. A specific problem is brachial plexus injuries where nerve roots can be ruptured, or even avulsed from the spinal cord, by traction. An early and correct diagnosis of a nerve injury is important. A thorough knowledge of the anatomy of the peripheral nerve trunk as well as of basic neurobiological alterations in neurons and Schwann cells induced by the injury are crucial for the surgeon in making adequate decisions on how to repair and reconstruct nerves. The technique of peripheral nerve repair includes four important steps (preparation of nerve end, approximation, coaptation and maintenance). Nerves are usually repaired primarily with sutures applied in the different tissue components, but various tubes are available. Nerve grafts and nerve transfers are alternatives when the injury induces a nerve defect. Timing of nerve repair is essential. An early repair is preferable since it is advantageous for neurobiological reasons. Postoperative rehabilitation, utilising the patients' own coping strategies, with evaluation of outcome are additional important steps in treatment of peripheral nerve injuries. In the rehabilitation phase adequate handling of pain, allodynia and cold intolerance are emphasised.

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The Role of Current Techniques and Concepts in Peripheral Nerve Repair

Plastic Surgery International ◽

10.1155/2016/4175293 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 26

Author(s):

K. S. Houschyar ◽

A. Momeni ◽

M. N. Pyles ◽

J. Y. Cha ◽

Z. N. Maan ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Regeneration ◽

Clinical Application ◽

Functional Recovery ◽

Nerve Repair ◽

Treatment Options ◽

Peripheral Nerve Injuries ◽

Nerve Injuries ◽

Peripheral Nerve Repair

Patients with peripheral nerve injuries, especially severe injury, often face poor nerve regeneration and incomplete functional recovery, even after surgical nerve repair. This review summarizes treatment options of peripheral nerve injuries with current techniques and concepts and reviews developments in research and clinical application of these therapies.

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Use of Vein Conduit and Isolated Nerve Graft in Peripheral Nerve Repair: A Comparative Study

Plastic Surgery International ◽

10.1155/2014/587968 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Imran Ahmad ◽

Md. Sohaib Akhtar

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Hand Function ◽

Study Groups ◽

Nerve Graft ◽

Motor Recovery ◽

Control Group ◽

Study Group ◽

Peripheral Nerve Repair ◽

Second Year

Aims and Objectives. The aim of this study was to evaluate the effectiveness of vein conduit in nerve repair compared with isolated nerve graft. Materials and Methods. This retrospective study was conducted at author’s centre and included a total of 40 patients. All the patients had nerve defect of more than 3 cm and underwent nerve repair using nerve graft from sural nerve. In 20 cases, vein conduit (study group) was used whereas no conduit was used in other 20 cases. Patients were followed up for 2 years at the intervals of 3 months. Results. Patients had varying degree of recovery. Sensations reached to all the digits at 1 year in study groups compared to 18 months in control group. At the end of second year, 84% patients of the study group achieved 2-point discrimination of <10 mm compared to 60% only in control group. In terms of motor recovery, 82% patients achieved satisfactory hand function in study group compared to 56% in control group (P<.05). Conclusions. It was concluded that the use of vein conduit in peripheral nerve repair is more effective method than isolated nerve graft providing good sensory and motor recovery.

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Techniques of Peripheral Nerve Repair

Neurosurgery Clinics of North America ◽

10.1016/s1042-3680(18)30759-9 ◽

1991 ◽

Vol 2 (1) ◽

pp. 93-104 ◽

Cited By ~ 20

Author(s):

Mark E. Harris ◽

Suzie C. Tindall

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Peripheral Nerve Repair

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Faculty Opinions recommendation of Passive transfer of IgG anti-GM1 antibodies impairs peripheral nerve repair.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4672010.4620060 ◽

2010 ◽

Author(s):

Zhigang He ◽

Kevin Park

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Passive Transfer ◽

Peripheral Nerve Repair

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Large Extremity Peripheral Nerve Repair

10.21236/ada597944 ◽

2013 ◽

Author(s):

Jonathan M. Winograd

Keyword(s):

Peripheral Nerve ◽

Nerve Repair ◽

Peripheral Nerve Repair

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The effects of sensory re-education on hand function recovery after peripheral nerve repair: A systematic review

Neurorehabilitation ◽

10.3233/nre-201612 ◽

2021 ◽

pp. 1-12

Author(s):

Weili Xia ◽

Zhongfei Bai ◽

Rongxia Dai ◽

Jiaqi Zhang ◽

Jiani Lu ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Nerve ◽

Nerve Repair ◽

Hand Function ◽

Current Evidence ◽

Motor Deficits ◽

Peripheral Nerve Repair ◽

Hand Functions ◽

Function Recovery ◽

Short And Long Term

BACKGROUND: Peripheral nerve injury can result in both sensory and motor deficits, and these impairments can last for a long period after nerve repair. OBJECTIVE: To systematically review the effects of sensory re-education (SR) on facilitating hand function recovery after peripheral nerve repair. METHODS: This systematic review was limited to articles published from 1970 to 20 December 2020. Electronic searching was performed in CINAHL, Embase, PubMed, Web of Science, and Medline databases to include trials investigating the effects of SR training on hand function recovery after peripheral nerve repair and included only those studies with controlled comparisons. RESULTS: Sixteen articles were included in final data synthesis. We found that only four studies could be rated as having good quality and noted obvious methodological limitations in the remaining studies. The current evidence showed that early SR with mirror visual feedback and the combinational use of classic SR and topical temporary anesthetic seemed to have long- and short-term effects, respectively on improving the sensibility and reducing the disabilities of the hand. The evidence to support the effects of conventional classical SR on improving hand functions was not strong. CONCLUSIONS: Further well-designed trials are needed to evaluate the effects of different SR techniques on hand function after nerve repair over short- and long-term periods.

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