Jabaley Epineurial Splint Technique versus Conventional Fascicular Group Neuroraphy in Median and Ulnar Nerves Reconstruction in the Forearm: Clinical Results

Introduction: The Jabaley’s technique is a FG suture technique in which the stress is taken-up by the epineurial splint sutured at a different level than the FG suture. The technique is more time consuming than a normal FG suture but more rapid than nerve grafting.

Methodology and Material: Between1989 and 2013 we performed 280 median and 315 ulnar nerves direct coaptation reconstruction in the forearm. In the median nerve, FG neuroraphy was performed in 52 cases of which we chose the Jabaley technique in 23 cases. In the ulnar nerve we performed FG neuroraphy in 110 cases of which 48 were repaired by the Jabaley technique.

The epineurial splint is created on the profound side of the nerve connected to the mezonerve, restauring the epineurial vascular support. The two flaps (proximal and distal) of the epineurial splint are tailored to be unequal. Thus the FG's suture line will be performed at a different level.

Results: Were good and excellent in 83,2% for the median nerve repaired by usual FG suture. By Jabaley repair 19 patients were good and excellent rate (82%) and for the ulnar nerve were good and excellent in 80,2%.

Conclusions: The advantages of this technique consists mainly of rendering possible a stressless fascicular group neuroraphy in border-line situations that normally impose nerve grafting, offers mechanical protection, resistance to elongation, internal and external gliding possibilities and vascular support by the epineurial vascularization.