Median nerve reconstruction
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Reconstruction of a peripheral nerve with autograft is a useful technique that has numerous applications including reconstruction of a nerve gap following trauma, and excision and grafting of a neuroma in continuity.
The following case serves to demonstrate the technique in a patient that had previously had treatment for a complete median nerve division at the wrist with surgical exploration and subsequent reconstruction of a nerve gap using processed nerve allograft.
The patient went on to have very little sensory or motor recovery through the allograft and developed a neuroma in continuity.
The decision was made to re-explore and to excise the graft and any proximal neuroma and perform a cabled autograft reconstruction using sural nerve autograft.
Author: Tahseen Chaudhry, Consultant hand and peripheral nerve surgeon
Institution: Peripheral Nerve Unit, Birmingham hand centre, Queen Elizabeth Hospital Birmingham, UK