[Results of 40 interfascicular grafting on peripheral nerve trunks]

The authors report 40 cases of interfascicular nerve grafts carried out since 1976 on the main peripheral nerves: 10 grafts of the median nerve, 21 grafts of the ulnar nerve, 8 grafts of the radial nerve and 1 graft of the sciatic nerve. In all cases, these are secondary grafts: either or first intention when the nervous section has been observed in emergency, the nervous ends being only brought together in these cases; or during an exploratory operation when faced by a lesion of unknown anatomical mechanism, These are interfascicular nerve grafts, according to Millesi, the donor nerve being represented by the sural nerve. The results, interpreted according to the criteria of the British Medical Research Council, are firstly analysed nerve by nerve, after discussion of age, level of injury, cause of injury, and above all, the delay between injury and the graft. The importance of associated damages is also discussed, specially vascular lesions. Several factors are influencing the quality of the results and among these are age, level and mechanism of the injury, the delay between injury and the graft, the length of the graft and number of cables. For that study, it is possible to conclude that the results are best when the patient is young, the delay short, the level distal, the length of the defect moderate and the number of cables is maximum. Finally, it appears from electrophysiological statements that this study is necessary to evaluate the quality of nervous regeneration, particularly at the median nerve, where the reinnervation is often supplied by the ulnar nerve (50% in our serie).