[Peripheral nerve repair: 30 centuries of scientific research].
BACKGROUND
Nerve injury compromises sensory and motor functions. Techniques of peripheral nerve repair are based on our knowledge regarding regeneration. Microsurgical techniques introduced in the late 1950s and widely developed for the past 20 years have improved repairs. However, functional recovery following a peripheral mixed nerve injury is still incomplete.


BACKGROUND
Good motor and sensory function after nerve injury depends on the reinnervation of the motor end plates and sensory receptors. Nerve regeneration does not begin if the cell body has not survived the initial injury or if it is unable to initiate regeneration. The regenerated axons must reach and reinnervate the appropriate target end-organs in a timely fashion. Recovery of motor function requires a critical number of motor axons reinnervating the muscle fibers. Sensory recovery is possible if the delay in reinnervation is short. Many additional factors influence the success of nerve repair or reconstruction. The timing of the repair, the level of injury, the extent of the zone of injury, the technical skill of the surgeon, and the method of repair and reconstruction contribute to the functional outcome after nerve injury.


CONCLUSIONS
This review presents the recent advances in understanding of neural regeneration and their application to the management of primary repairs and nerve gaps.
Desouches
C
C
Service de Chirurgie de la Main, Chirurgie Plastique et Réparatrice des Membres, Assistance Publique, Hôpitaux de Marseille, Hôpital de la Conception, Marseille.
Alluin
O
O
Mutaftschiev
N
N
Dousset
E
E
Magalon
G
G
Boucraut
J
J
Feron
F
F
Decherchi
P
P
D001369:Axons / Q000502:physiology; D003393:Cranial Sutures / Q000502:physiology; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D008264:Macrophages / Q000502:physiology; D008866:Microsurgery / Q000266:history* / Q000379:methods*; D009412:Nerve Fibers / Q000502:physiology; D009416:Nerve Regeneration / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D019635:Neurosurgical Procedures / Q000266:history* / Q000379:methods*; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000601:surgery*; D012583:Schwann Cells / Q000502:physiology