J Reconstr Microsurg 2006; 22 - A062
DOI: 10.1055/s-2006-949049

Endoscopically-Assisted Sural Nerve Harvest for Upper Extremity Post-Traumatic Nerve Defects: Evaluation of Functional Outcomes

Chih-Hung Lin 1, 2, Samir Mardini 1, 2, L. Scott Levin 1, 2, Yu-Te Lin 1, 2, Jun-Tin Yeh 1, 2
  • 1Division of Trauma, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • 2Duke University Medical Center, Durham, North Carolina, USA

Endoscopic sural nerve graft may provide advantageous cosmesis and less donor-site pain. The results of endoscopically harvested nerve graft for upper limb nerve defect are of concern regarding surgical safety and functional predictability.

Fifteen patients underwent endoscopic sural nerve grafts for post-traumatic upper limb segmental nerve defects. One lateral ankle 4-cm incision was made and the nerve was dissected under videomonitor visualization atraumatically. The functional results were assessed using British Medical Research Council scales.

A prehensile sensation between S3 and S4 on the scale can be achieved. Motor function can be M1+ to M5 on the scale. The remaining motor function impairment requires subsequent tenolysis for post-traumatic tendon adhesion, or tendon transfer for median and ulnar nerve intrinsic palsy. Finally, the patients can have an M4 or M5 evaluation and good grip power.

Endoscopic sural nerve grafting is not a time-consuming procedure, and it can provide a reasonable and predictable functional result.