Basic Science of Muscle Neurotization: A Review

Traumatic nerve injuries continue to be considered a challenge in the field of nerve microsurgical reconstruction. Despite the advances in microsurgical repair techniques, motor function recovery is not adequate in severe nerve injuries, especially when there is separation of the motor nerve from the muscle tissue. The technique of reinnervating skeletal muscles by insertion within it of a donor nerve was developed at the beginning of the 20th century during World War I, when injuries and poliomyelitis produced paralytics for whom no therapy was available. Only a few reports of clinically successful reinnervation exist, and clinical application of the method during the following decades has been limited. However, the functional value of this procedure remains a matter of controversy. The purpose of this review is to present what is known in basic science about direct neurotization of muscle along with a brief historical review.