Reconstructive surgery of the peripheral nerves in the upper extremities with autografts

PURPOSE OF THE STUDY The author presents results of 42 surgeries performed by microtechnique in 42 patients within the treatment of 45 nerves in the period of 15 years, i.e. between 1985 and 1999. MATERIAL Forty-five nerves were reconstructed in 42 patients with a lesion of peripheral nerves of upper limbs by means of autografts. METHOD The efficiency of the surgery was analyzed on the basis of the following indicators: the interval between the injury and surgery, the patient's age, length of autograft, nature of injury, level of injury, type of the injured nerve. In the evaluation we used Sedon's classification of motor and sensitive functions of 1975. RESULTS The best results were achieved in young patients up to the age of 20, in timely operations within 3 months, in nerve grafts up to the length of 5 cm. A simple cut wound provides much better conditions for a successful auto-transplantation of a nerve graft as compared to other more complicated injuries (e.g. lacerated wound or contusion). CONCLUSIONS A timely surgical revision combined with neurolysis and, if need be, with a reconstruction surgery is in indicated cases a decisive factor influencing the outcome of the surgery.