Overview of Nerve Graft Repair
When a nerve has been injured, the goal of surgical repair is generally to reapproximate the ends of the injured nerve. Sometimes during repair after a nerve injury, a portion of the injured nerve, called a neuroma, needs to be excised, leaving a gap. When the nerve ends cannot be brought together, then a nerve graft may be necessary.
Nerve grafts are generally portions of a sensory nerve that are harvested from another part of the body to be used as graft material. Once the graft is in place, the regenerating nerve fibers grow from the proximal nerve stump, through the graft, through the distal nerve segment into the target muscles. Thus, patients may recover function in muscles following graft repair of nerve injuries.
Sural nerve, superficial radial sensory, and medial antebrachial cutaneous nerve are common donor nerves for graft material.
Figure 1. Intraoperative photograph during the repair of a sciatic nerve injury that resulted in a gap in the peroneal division of the sciatic nerve.
Figure 2. Intraoperative photograph of the patient in Figure 1 following microsurgical placement of several sural nerve grafts to bridge the gap in the sciatic nerve.