Nerve repair by means of vein filled with muscle grafts I. Clinical results

Peripheral nerve lesions with a long segment defect need a grafting conduit to heal. Although autogenous nerve grafting is still considered the best m ethod for bridging nerve defects, several alternative types of conduits (bi ological and synthetic) have been studied. We have demonstrated in previous experimental research in rats that a graft made using a vein (providing a guide for nerve regeneration) filled with fresh skeletal muscle (to prevent vein collapse and support axon regeneration) gave similar results to tradi tional nerve grafts. On this basis, we decided to use the muscle-vein-combi ned grafts in clinical cases. From 1993 to 1997, this technique was applied for bridging both sensory and mixed nerve defects (21 cases). We report go od results in 85% of our cases with a minimum follow-up of 14 months. These results, obtained on nerve defects ranging from 0.5 to 6 cm in length, see m to be superior to those reported with other kinds of artificial or biolog ical conduits. (C) 2000 Wiley-Liss, Inc.