Split nerve grafting

Twenty-five patients with severe brachial plexus lesions (having a rather poor prognosis in general), were subjected to a variety of split nerve graft procedures, with 22 achieving useful functional recovery. Thirty-eight nerves were reconstructed, with 32 of them achieving useful recovery. Results in these patients were no better nor worse than those obtained with other types of nerve grafts (e.g., free cutaneous nerve grafts, vascularized nerve grafts, etc.). The technique of splitting the nerve for the use of split fascicle groups as free nerve grafts is nevertheless recommended as an alternative to the application of the ulnar nerve as a vascularized nerve graft. The plexiform arrangement of the fascicles within the ulnar nerve apparently does not preclude the possibility of harvesting sufficiently long nerve grafts.