Lesions of peripheral nerves, especially those serving important motor effectors and sensitive areas, such as those in the upper extremities, can be extremely crippling. Not surprisingly, surgical repair of such lesions has been attempted for many decades, but it was not possible to claim consistent succes until many lessons had been learned by trial and error. One of the more important facts emerging was that end-to-end sutures could only be expected to yield functional recovery if the anastomosis was not subjected to axial tension. Extreme measures, including extensive nerve mobilisation, re-routing, limb flexion, nerve stretching and even bone shortening were applied to facilitate nerve suturing. Using these measures, Seddon (1947, 1954) achieved success in 71% of his cases and Woodhall and Beebe (1956) in 74.8% of their cases drawn from their Second World War Experience, although the anastomosis was not always free from tension. The cases described included a number in which the posttraumatic defect between the two ends of the nerves exceeded 20 centimeters. In such cases, end-to-end anastomosis without tension is out of the question and recovery is not always possible. Seddon (1954) pointed out, therefore, that the number of cases in which nerve suturing was indicated - not merely technically possible - was appreciably less than 70%.

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D.L. Westbroek , S.A. de Lange
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Singh, R. (1983, November 2). Histocompatibility matching and preserved nerve allografts in dogs. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/37586