Comparison of different methods of repair of long peripheral nerve defects: an experimental study

In order to compare the performance of free nerve grafts, vascularised nerve grafts, and freeze-thawed muscle autografts for the repair of long nerve defects an experimental study was undertaken in the rabbit peroneal nerve. 5 cm defects were repaired using each method. Recovery of function was assessed after 250 days using sensory and motor physiology, and histological examination of the nerve. Reliable recovery occurred with both types of nerve graft but not with muscle grafts. Vascularised nerve grafts performed better than free nerve grafts on all parameters measured but this only reached statistical significance for sensory receptive areas and myelinated fibre diameters distal to the grafts. The role of each method of repair in peripheral nerve surgery is reviewed.