Interposed muscle grafts in nerve repair in the hand: an experimental basis for future clinical use

Repair of digital nerves and the larger nerves supplying the hand is a common clinical problem. A number of options exist for either direct repair or reconstitution using an interposed graft. Each of these options is associated with a set of problems peculiar to itself and to nerve repair in general. The heterogeneity of nerve injuries and of the various methods of repair and assessment has not led to the establishment of clear comparisons and guidelines for surgical intervention. Recently, freeze-thawed coaxially aligned skeletal muscle autografts have been added to the list of available grafting techniques. The present article discusses the genesis of the muscle graft technique and examines steps which have been taken to elucidate its performance in controlled laboratory conditions. The extent to which these experimental observations provide a foundation for the clinical use of muscle grafts is discussed.