Chapter

Clinical Nerve Repair And Grafting

Thomas M. Brushart

in Nerve Repair

Published on behalf of Oxford University Press

Published in print May 2011 | ISBN: 9780195169904
Published online September 2012 | e-ISBN: 9780199965168 | DOI: http://dx.doi.org/10.1093/med/9780195169904.003.0005
Clinical Nerve Repair And Grafting

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  • Sensory and Motor Systems
  • Rehabilitation Medicine

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The results of median and ulnar nerve repair and grafting indicate that 1) Age is the primary determinant of outcome after neural repair or grafting, 2) The proximo-distal level of injury influences motor but not sensory recovery, 3) Delay in repair adversely affects outcome, 4) Functional recovery decreases as the severity of injury to the nerve increases, 5) The use of the operating microscope and microsutures improves the results of nerve repair, 6) Functional restoration after nerve grafting deteriorates as graft length increases, and 7) The outcome of nerve grafting is equal to that of nerve repair in distal nerves that serve a single function. Including additional nerves in the analysis revealed that false sensory localization after median nerve repair and synkinesis after facial nerve repair suggest the absence of topographic specificity in both sensory and motor regeneration. Many of these clinical findings can be restated biologically in terms of intraneural organization, the effects of denervation time on regeneration, and age-related changes in gene expression. This restatement facilitates the design of strategies to improve the persistently disappointing results of nerve repair and grafting.

Chapter.  14933 words.  Illustrated.

Subjects: Sensory and Motor Systems ; Rehabilitation Medicine

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