Clinical application of motorsensory differentiated nerve repair

Since 1979 acetylcholinesterase has been used in clinical practice for motor sensory differentiation. It was first used for median and ulnar nerve injuries at the wrist. Recently the application was extended to secondary nerve repair, including plexus reconstruction. The aim of this study was to present, for the first time, clinical results of motor sensory differentiated median and ulnar nerve repair and to show the advantage of this method in secondary repair. We compared a group of nine patients with motor sensory differentiated median and ulnar nerve repair with a group of 13 patients without motor sensory differentiation. Sensibility testing, strength measurements, and anatomical examinations were performed. The hand function was expressed in percentage values. Compound muscle action potentials and sensory antidromic conduction velocities were measured electroneurographically. Sensibility recovery was significantly better after motor sensory differentiated median nerve repair (P < 0.05). In secondary nerve repair acetylcholinesterase was used additionally for evaluating the level of resection of the proximal stump. The time required for perioperative histochemical differentiation has now been reduced to 2 hr.