Peripheral Nerve Gap Repair Facilitated By a Dynamic Tension Device

Abstract

End-to-end neurorrhaphy remains the gold standard for transected nerve repair. However, the current dogma is that to be successful, nerve repairs must be tension free. Therefore, nerve gaps are most commonly repaired with grafts. While there is evidence that nerves can regenerate successfully after initial approximation under a tensile force, the amount of tension that deters regeneration of human nerves remains unclear. The present paper describes a case in which a favourable functional outcome was obtained following repair of a median nerve gap that was reduced by a dynamic tension device. The case provides some evidence that modest separations between stumps can be overcome by dynamic tension, enabling primary end-to-end repair of nerve gaps.