Interfascicular transplantation in median nerve injuries

Area of Science:

• Neurosurgery
• Microsurgery
• Peripheral Nerve Repair

Background:

• Complete median nerve transection presents significant challenges for functional recovery.
• Microsurgical techniques are crucial for optimizing outcomes in nerve repair.

Purpose of the Study:

• To evaluate the long-term functional outcomes of microsurgical interfascicular transplantation for complete median nerve transection.
• To compare the efficacy of interfascicular transplantation with epineurial suture techniques.

Main Methods:

• Retrospective analysis of 24 patients undergoing microsurgical interfascicular transplantation for median nerve repair.
• Minimum follow-up period of 3 years.
• Assessment of functional motor recovery (Medical Research Council scale grade M3 or higher) and tactile sensibility.

Main Results:

• 83% of patients achieved functional motor recovery (M3+).
• 96% of patients regained protective tactile sensibility.
• Outcomes were superior in distal lesions and in pediatric and young adult patients.
• The technique demonstrated superiority over epineurial end-to-end suture for nerve defects exceeding 2.5 cm.

Conclusions:

• Microsurgical interfascicular transplantation is a highly effective method for treating complete median nerve transections.
• This technique yields excellent functional motor and sensory recovery, comparable to epineurial sutures under ideal conditions.
• Interfascicular transplantation is the preferred method for managing longer nerve gaps.