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. 2015 Feb;29(1):40-7.
doi: 10.1055/s-0035-1544169.

Principles of nerve repair in complex wounds of the upper extremity

Amy M Moore  1 , I Janelle Wagner  1 , Ida K Fox  1
Affiliations

Principles of nerve repair in complex wounds of the upper extremity

Amy M Moore et al. Semin Plast Surg. 2015 Feb.

Abstract

Peripheral nerve injuries are common in the setting of complex upper extremity trauma. Early identification of nerve injuries and intervention is critical for maximizing return of function. In this review, the principles of nerve injury, patient evaluation, and surgical management are discussed. An evidence-based approach to nerve reconstruction is reviewed, including the benefits and limitations of direct repair and nerve gap reconstruction with the use of autografts, processed nerve allografts, and conduits. Further, the principles and indications of commonly used nerve transfers in proximal nerve injuries are also addressed.

Keywords: mutilating injury of the hand; nerve conduit; nerve transfer; peripheral nerve injury; processed nerve allograft; upper extremity trauma.

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Figures

Fig. 1
Fig. 1
Intraoperative images of reconstruction of the median and partial radial nerves with nerve grafting in the setting of a brachial artery repair. (A) Right arm wound after vein grafting of the brachial artery. (B) Median and radial nerves identified. (C) Median and radial nerve repaired with autograft cables. (D) Repair of the biceps tendon to complete the reconstruction of the extremity after a complex laceration.
Fig. 2
Fig. 2
Key principles of nerve management in complex trauma.
See this image and copyright information in PMC

References

    1. Fox I K, Mackinnon S E. Adult peripheral nerve disorders: nerve entrapment, repair, transfer, and brachial plexus disorders. Plast Reconstr Surg. 2011;127(5):105e–118e. - PMC - PubMed
    1. Moore A M Novak C B Advances in nerve transfer surgery J Hand Ther 201427296–104., quiz 105 - PubMed
    1. Mackinnon S E. New directions in peripheral nerve surgery. Ann Plast Surg. 1989;22(3):257–273. - PubMed
    1. Secer H I Daneyemez M Tehli O Gonul E Izci Y The clinical, electrophysiologic, and surgical characteristics of peripheral nerve injuries caused by gunshot wounds in adults: a 40-year experience Surg Neurol 2008692143–152., discussion 152 - PubMed
    1. Bercik M J, Kingsbery J, Ilyas A M. Peripheral nerve injuries following gunshot fracture of the humerus. Orthopedics. 2012;35(3):e349–e352. - PubMed