Median and ulnar nerve transections treated with microsurgical interfascicular cable grafting with autogenous sural nerve

Publisher Website
Google Scholar
Abstract
Interfascicular nerve grafting was used in 37 median and 26 ulnar nerves, all completely transected. In a follow-up period of 2.5-5 yr, useful motor recovery (M3 or higher) was achieved in 84% of median nerve lesions; in ulnar nerve lesions, useful motor recovery (M2 + or higher) was achieved in 73%. Sensory recovery with some return of 2-point discrimination sense was found in 63% of low median and 50% of low ulnar nerve lesions. In the median nerve group, patients younger than 20 yr old were treated significantly better than in older patients. Neurophysiological evidence for nerve regrowth through the grafts occurred in all but 1 patient, although the loss of axons was probably considerable if the amplitudes of sensory potentials were used as a parameter. Grafts of 2.5-5 cm in length were better than longer grafts and distal median nerve lesions were superior to those for the distal ulnar nerve lesions. Use of interfascicular nerve grafting techniques for nerve gaps > 2.5 cm is recommended.