NERVE GRAFTING IN PERIPHERAL-NERVE MICROSURGERY OF THE UPPER EXTREMITY

The use of microsurgical techniques is essential in peripheral nerve s urgery, in which dissection at the fascicular level is required. Magni fication with an operating microscope allows for an accurate evaluatio n of the severity of the trauma to the nerve tissue and permits atraum atic interfascicular dissection. Fascicular or interfascicular dissect ion and repair with the use of nerve grafts was carried out in 220 per ipheral nerve lesions of the upper extremity. Our results of nerve-gra fting in the upper extremity (median, ulnar, and radial-nerves) indica te an inverse association between the age of the patient and the delay between injury and grafting. In addition, we found that nerve graftin g without tension produces superior results over simple neurorrhaphy u nder tension and permits better axonal growth and nerve recovery. (C) 1994 Wiley-Liss, Inc.