A prospective study was conducted of patients suffering from gunshot and stab peripheral
nerve injuries in order to show that functional improvement was possible after interfascicular
neurolysis or interfascicular nerve grafts, even more than 1 year after injury.
Clinical and electrophysiological data on 140 patients were compared before and after
interfascicular neurolysis or nerve grafts. Microsurgery was performed during the
first year or 1 to 5 years after injury. Follow-up after the operation was from 1
to 5 years. A statistical clinical and electrophysiological analysis was done in order
to compare motor functional activity using MRC grade scale prior to and after surgery;
to compare amplitude and latency changes of compound muscle action potentials (CMAP)
and recruitment (voluntary muscle activity) prior to and after the surgery.
Statistically significant improvement in muscle strength occurred after microsurgery,
compared to before repair—gunshot wounds (p < 0.001) and stab wounds (p < 0.001).
Postoperative electrophysiological analysis showed statistically significant improvement
in amplitude of CMAP (p < 0.001) and recruitment (p = 0.002), compared to before surgery.
Although the optimal period for microsurgery of penetrating peripheral nerve injuries
is between 3–6 months, in cases where microsurgery was delayed, it also could progressively
improve nerve function.
