Nerve Grafting (peripheral nerve disorders)

If the ends of a cut or damaged nerve do not reach, then a nerve graft needs to be placed in between. This is often the case with stretch injuries or when there is extensive scar in the nerve that has to be removed.

The nerve graft is taken from your leg, usually the sural nerve, which is a sensory nerve behind the calf. In removing this nerve you will have a patch of numbness on the side of your foot, which mostly resolves in 6-12 months. The nerve fibers in the graft tissue quickly dissolve, but the channels for new nerves to regenerate, as well as required growth factors still remain. Therefore once connected, the injured nerve fascicles grow through this graft.

The grafts are sutured to the ends of the injured nerve with fine sutures using a microscope. Depending on the size of the injured nerve, multiple grafts may be required to repair the nerve. Longer the nerve graft, less likely that it will be successful.

Nerve Grafting

This patient had a disruption
of their posterior interosseous
nerve. The distal nerve stump
(above, asterisk) was removed
and the nerve was repaired with
two sural nerve grafts (below,
arrowheads). The proximal
graft connection (not shown) is
on the other side of the extensor
muscle mass (rubber loop).

 

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