Advances of Peripheral Nerve Repair Techniques to Improve Hand Function: A Systematic Review of Literature

Abstract

<jats:p>Concepts of neuronal damage and repair date back to ancient times. The research in this topic has been growing ever since and numerous nerve repair techniques have evolved throughout the years. Due to our greater understanding of nerve injuries and repair we now distinguish between central and peripheral nervous system. In this review, we have chosen to concentrate on peripheral nerve injuries and in particular those involving the hand. There are no reviews bringing together and summarizing the latest research evidence concerning the most up-to-date techniques used to improve hand function. Therefore, by identifying and evaluating all the published literature in this field, we have summarized all the available information about the advances in peripheral nerve techniques used to improve hand function. The most important ones are the use of resorbable poly[(R)-3-hydroxybutyrate] (PHB), epineural end-to-end suturing, graft repair, nerve transfer, side to side neurorrhaphy and end to side neurorrhaphy between median, radial and ulnar nerves, nerve transplant, nerve repair, external neurolysis and epineural sutures, adjacent neurotization without nerve suturing, Agee endoscopic operation, tourniquet induced anesthesia, toe transfer and meticulous intrinsic repair, free auto nerve grafting, use of distal based neurocutaneous flaps and tubulization. At the same time we found that the patient’s age, tension of repair, time of repair, level of injury and scar formation following surgery affect the prognosis. Despite the thorough findings of this systematic review we suggest that further research in this field is needed.</jats:p>

Long term results of primary repair of combined cuts of median and ulnar nerves on forearm

“…A discussion still persists on Özaksar et al Long-term results of primary repair of combined cuts on the median and ulnar nerves in the forearm this subject. [17][18][19] The general impression focuses on obtaining nerve integrity using simple suture techniques.…”

Regeneración de las lesiones críticas del nervio periférico con factores de crecimiento. Estudio experimental

“…Después se siguen dando puntos en toda la periferia del nervio. Este tipo de sutura, se combina modernamente con el anclaje de algunos puntos en el perineuro de los fascículos más periféricos para mejorar el afrontamiento y evitar que aquellos se inviertan (Merle et al, 1993;Mafi et al, 2012).…”

The Effect of Muscle Graft with Nerve Growth Factor and Laminin on Sciatic Nerve Repair in Rats

“…The most severe of which is called neurotmesis that results in the loss of nerve trunk continuity, myelin sheath, and the surrounding connective tissues. If there is no gap between the cut endings of the nerve, or if the gap is short, the two nerve endings can be directly sutured, and the result of healing will depend on whether the nerve bundles at the cut endings to adhere to each other correctly (Mafi, Hindocha, Dhital, & Saleh, 2012).…”