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Review
. 2024 Apr 10;6(5):691-693.
doi: 10.1016/j.jhsg.2024.01.018. eCollection 2024 Sep.

The Role of Nerve Tension on Nerve Repair Success

Thomas J McQuillan  1 , Nicole A Zelenski  1 , Paul A Ghareeb  1
Affiliations
Review

The Role of Nerve Tension on Nerve Repair Success

Thomas J McQuillan et al. J Hand Surg Glob Online. .

Abstract

Peripheral nerve injuries that are not acutely repaired may lead to a nerve gap because of the surrounding zone of injury and elastic recoil of nerve tissue after laceration. This can result in tension across the repair site during primary neurorrhaphy. Decades of basic science literature using in vivo models consistently demonstrate a relationship between increasing strain at a neurorrhaphy site and compromised microvascular blood flow. Clinical and laboratory data suggest tension-free repairs are associated with optimal outcomes; in the setting of a short segmental nerve gap, data suggest primary repair may continue to yield good functional results. In the case of high strain, nerve grafting or other methods should be considered given poor results of primary repairs performed under high tension because of local ischemia and fibrosis on a cellular level.

Keywords: Graft; Nerve; Neurorrhaphy; Repair; Tension.

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Conflict of interest statement

No benefits in any form have been received or will be received related directly to this article.

Figures

Figure 1
Figure 1
Stress versus strain: applied loads of nerves under tension.
See this image and copyright information in PMC

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