RESEARCH ARTICLE


Peripheral Nerve Injury: Principles for Repair and Regeneration



Griffin M.F1, Malahias M1, Hindocha S*, 2, Wasim S Khan 3
1 Plastic Surgery Department, Good Hope Hospital, West Midlands, B75 7RR, UK
2 Plastic Surgery Department, Whiston Hospital, Liverpool, L35 5DR, UK
3 University College London Institute of Orthopaedics & Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, London, HA7 4LP, UK


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© Griffin et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Plastic Surgery, Whiston Hospital, Warrington Road, L355DR, UK; Tel: + 44(0)1244366265; Fax: +44(0)1244366266; E-mail: hindocha2001@yahoo.com


Abstract

Peripheral Nerve Injuries are one of the most common causes of hand dysfunction caused by upper limb trauma but still current management has remained suboptimal. This review aims to explain the traditional view of pathophysiology of nerve repair and also describe why surgical management is still inadequate in using the new biological research that has documented the changes that occur after the nerve injury, which, could cause suboptimal clinical outcomes. Subsequently presentation and diagnosis will be described for peripheral nerve injuries. When traditional surgical repair using end-to-end anastomosis is not adequate nerve conduits are required with the gold standard being the autologous nerve. Due to associated donor site morbidity and poor functional outcome documented with autologous nerve repair several new advancements for alternatives to bridge the gap are being investigated. We will summarise the new and future advancements of non-biological and biological replacements as well as gene therapy, which are being considered as the alternatives for peripheral nerve repair.

Keywords: Anastamosis, biological replacements, clinical outcome, nerve repair, peripheral nerves..