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Related Experiment Videos

The nerve gap. Theory and clinical practice.

H Millesi

    Hand Clinics
    |November 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Peripheral nerve gaps result from nerve defects or elastic retraction, influenced by joint position. Nerve adaptation involves elongation, longitudinal movement, and tissue relaxation, with free nerve grafts being the most reliable repair method.

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    Area of Science:

    • Peripheral Nerve Surgery
    • Neuroscience
    • Biomechanical Engineering

    Background:

    • A nerve gap is the distance between transected peripheral nerve stumps.
    • Gap formation is influenced by true nerve defects, elastic retraction, and joint position.
    • Nerve adaptation to length changes during limb motion is crucial for function.

    Purpose of the Study:

    • To analyze factors contributing to peripheral nerve gap formation.
    • To understand nerve adaptation mechanisms during limb motion.
    • To evaluate methods for bridging peripheral nerve gaps.

    Main Methods:

    • Analysis of factors influencing nerve gap formation.
    • Estimation of nerve length adaptation during joint motion (e.g., median nerve at the elbow).

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  • Review of nerve adaptation mechanisms: true elongation, longitudinal movement, and tissue relaxation.

    • Main Results:

    • Nerve gap length is significantly influenced by joint position.
    • Three primary adaptation mechanisms: nerve elongation, trunk movement, and changes in nerve fiber undulation.
    • Adhesions impede force distribution, increasing traction stress.
    • True nerve elongation has limited capacity for bridging gaps.

    Conclusions:

    • Nerve adaptation to length differences involves complex biomechanical processes.
    • Free nerve grafting, particularly using autologous cutaneous nerve segments, is the most reliable technique for bridging nerve gaps.
    • Alternative strategies like rerouting and limb-shortening exist, while neuromatous neurotization remains experimental.