Median nerve as free tendon graft

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Hand Surgery

Background:

• Median nerve reconstruction is crucial for restoring function after tendon injuries.
• Free tendon grafts are utilized in complex reconstructive surgeries.
• The palmaris longus tendon is a common autograft source, but its absence can complicate procedures.

Observation:

• Four patients with tendon injuries underwent median nerve reconstruction using a free sural nerve graft.
• Three cases involved flexor tendon repair, and one involved extensor tendon repair.
• The palmaris longus tendon was congenitally absent in all four patients.

Findings:

• The median nerve served effectively as a free tendon graft in these cases.
• Reconstruction of the median nerve with a sural nerve graft was successfully performed.
• The absence of the palmaris longus tendon presented a surgical challenge.

Implications:

• This case series demonstrates the viability of the median nerve as a tendon graft alternative.
• Preoperative assessment for the presence of the palmaris longus tendon is critical for surgical planning.
• Alternative autograft sources should be considered when the palmaris longus tendon is unavailable.