Tubular repair of the median nerve in the human forearm. Preliminary findings

J Hand Surg Br. 1994 Jun;19(3):273-6. doi: 10.1016/0266-7681(94)90068-x.

Abstract

Transected median nerves in the forearm of two male patients, 12 and 21 years of age, were treated with a chamber technique leaving a 3 to 5 mm gap between the nerve ends. The nerve ends were enclosed in a silicone tube of such a dimension that would not cause compression of the nerve. Post-operative examination including sensory evaluation and assessment of muscle contraction force was carried out after 3 years. In both cases there was excellent motor recovery of the thenar muscles. Outgrowth of sensory fibres was remarkably fast, resulting ultimately in functional sensibility allowing almost normal hand function. 2PD was < or = 6 mm (12-year-old patient) and 8 to 10 mm (21-year-old patient) respectively. In one case the silicone tube was re-explored because of minor local discomfort 2 years after the repair. The former gap was bridged by a smooth continuous nerve-like structure of the same diameter as the adjacent nerve trunk and with no signs of neuroma formation or compression of the nerve.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Axons / physiology
  • Child
  • Follow-Up Studies
  • Forearm / innervation*
  • Hand / physiology
  • Humans
  • Intubation*
  • Male
  • Median Nerve / injuries*
  • Median Nerve / pathology
  • Median Nerve / physiopathology
  • Median Nerve / surgery*
  • Motor Neurons / physiology
  • Muscle Contraction / physiology
  • Nerve Regeneration / physiology
  • Neurons, Afferent / physiology
  • Pressure
  • Sensation / physiology
  • Silicones*
  • Suture Techniques
  • Touch / physiology
  • Vibration

Substances

  • Silicones