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Traumatic Peripheral Nerve Injury in Mice
Published on: March 25, 2022
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Comparative Outcomes of Direct Versus Connector-Assisted Peripheral Nerve Repair
Edoardo Agosti1, Marco Zeppieri2,3, Tamara Ius4
1Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy.
Biomedicines
|December 30, 2025
Summary
Connector-assisted repair (CAR) shows better sensory recovery for upper extremity nerve injuries than direct repair (DR). However, DR is effective for closely approximated nerves, and more research is needed.
Area of Science:
- Orthopedics
- Neurosurgery
- Regenerative Medicine
Background:
- Peripheral nerve injuries are common in upper extremity trauma, often requiring surgical repair.
- Direct repair (DR) is standard, but limitations like misalignment and tension exist.
- Connector-assisted repair (CAR) aims to improve outcomes by overcoming DR limitations.
Purpose of the Study:
- To systematically review and compare the clinical effectiveness of DR versus CAR for upper extremity peripheral nerve injuries.
- To evaluate complication rates associated with both repair methods.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Ovid MEDLINE (1980-2025).
- Inclusion of studies reporting sensory outcomes using the Medical Research Council Classification (MRCC) scale.
- Primary outcome: meaningful sensory recovery (MRCC ≥ S3); Secondary outcomes: complications like neuroma, pain, and revision rates.
Main Results:
- CAR showed higher sensory recovery (69.3%) compared to DR (50.8%).
- DR had lower rates of cold intolerance, altered sensation, and pain.
- CAR had higher rates of neuromas, revisions, and fistulas; DR showed better motor recovery.
Conclusions:
- CAR offers superior sensory recovery and reduced cold intolerance for small-gap nerve injuries.
- DR remains suitable for closely approximated nerves.
- Heterogeneous evidence necessitates randomized trials to confirm findings.
