Sural nerve autografts for high radial nerve injury with nine centimeter or greater defects.
OBJECTIVE
The purpose of this study is to present the outcome of sural nerve grafting that focuses on motor fascicles in 6 patients with high radial nerve injuries with defects of more than 9 cm.


METHODS
Six patients with a high radial nerve complete injury were treated with a sural nerve autograft during a 6-year interval from June 1994 to June 2000. The gap of the radial nerve, which was measured in the surgical field, was 9 cm in 1 patient, 10 cm in 4 patients, and 11 cm in 1 patient. There were 4 men and 2 women with an average age of 32 years (range, 14-49 years). The causes of the injuries were a fracture of the humerus in 4 patients and surgery-related complications in 2 patients. Two or 3 multiple interfascicular nerve autografts of the sural nerve were sutured to the areas that have motor fascicles dominantly. The average delay from the injury to surgery was 6 months (range, 0.5-12 months), and the average duration of the follow-up after surgery was 48 months.


RESULTS
The overall motor recovery was M5 in 2 patients, M4 in 3 patients, and M2 in 1 patient. The overall sensory recovery was S3+ in 2 patients, S3 in 3 patients, and S1 in 1 patient.


CONCLUSIONS
In summary, good to excellent motor recovery can be expected in 83% of patients who have a large gap of the radial nerve when sural nerve autografts are sutured to the areas that have motor fascicles dominantly. Even for large gaps, within 8 months, an attempt at nerve reconstruction before proceeding to tendon transfers appears to be indicated.


METHODS
Therapeutic IV.
Lee
Young Ho
YH
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Chung
Moon Sang
MS
Gong
Hyun Sik
HS
Chung
Jae Yoon
JY
Park
Jong Hyun
JH
Baek
Goo Hyun
GH
D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D011826:Radial Nerve / Q000293:injuries* / Q000473:pathology; D020127:Recovery of Function; D012189:Retrospective Studies; D013497:Sural Nerve / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome