chapter  15
12 Pages

End-to-side neurorrhaphy: an alternative method for reinnervation in cases with long nerve defects

ByManfred Frey, Pietro Giovanoli

The results of surgical reconstruction by proximal nerve repair or with long nerve grafts are often not satisfying clinically. Recovery of motor and sensory function depends on a critical number of axons reaching the target organ and on reinnervating muscle fibres and sensory receptors within a critical period after denervation. In limited cases, like in avulsion injuries, where no donor nerve or nerve transfer is available for direct end-to-end suture, or in cases where extremely long distances have to be overcome by the regenerating axons and limited functional results are to be expected, end-to-side suture of the distal part of the injured nerve to an uninjured nerve in the neighbourhood may offer a practical solution.