This article reviews the anatomy of the peripheral nerve, the pathophysiolo
gy of nerve injury, and Wallerian degeneration. It reviews the factors for
deciding on immediate or delayed primary nerve repair and discusses the con
cept of longitudinal excursion of peripheral nerves about joints and the te
chniques for achieving an appropriate tension-free repair. The techniques o
f primary nerve repair, epineurial repair, and group fascicular repair are
reviewed along with techniques for matching fascicles intraoperatively.