Interfascicular Grafts of Non-Nerve Tissues for Gaps in Peripheral Nerve Trunks

Abstract

Ten cases with gaps in nerve trunks in the forearm were treated by interfascicular grafts of autogenous veins. These included three cases of median nerve injuries, five cases of ulnar nerve injuries and two cases of radial sensory nerve injuries. The nerve gaps ranged from 1.5 to 4.5 cm with an average of 3 cm. Completely divided nerve trunks were repaired by two or three vein conduits. For incomplete nerve injuries or replacement of a single fasciculus, a single vein conduit was used. For nerve defects over 3 cm, normal nerve tissues were sectioned from the proximal nerve fasciculus and inserted into the vein conduits. These cases were followed for 2 years and 2 months to 3 years. The results were M3 in two, M4 in six and S2 + in two, S3 + in seven and S4 in one nerves. This study suggests that interfascucular grafts of vein conduits can be applied in patients with nerve gaps shorter than 4.5 cm and with favourable wound conditions with fairly good clinical results. Interfascicular vein graft provides an alternative treatment option for gaps in distal peripheral nerve trunks.