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Semin Plast Surg 2015; 29(01): 040-047
DOI: 10.1055/s-0035-1544169
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Principles of Nerve Repair in Complex Wounds of the Upper Extremity

Amy M. Moore
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
,
I. Janelle Wagner
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
,
Ida K. Fox
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
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Publication History

Publication Date:
04 February 2015 (online)

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Abstract

Peripheral nerve injuries are common in the setting of complex upper extremity trauma. Early identification of nerve injuries and intervention is critical for maximizing return of function. In this review, the principles of nerve injury, patient evaluation, and surgical management are discussed. An evidence-based approach to nerve reconstruction is reviewed, including the benefits and limitations of direct repair and nerve gap reconstruction with the use of autografts, processed nerve allografts, and conduits. Further, the principles and indications of commonly used nerve transfers in proximal nerve injuries are also addressed.

Keywords

upper extremity trauma - peripheral nerve injury - nerve transfer - processed nerve allograft - nerve conduit - mutilating injury of the hand
 

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