NERVE SURGERY

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Nerves are like electrical wires in our body. They relay electrical impulses from our central nervous system to the periphery and back. Without nerves, we lose our ability to move and perceive our surroundings. Needless to say, nerve injuries can leave us disabled and unable to work. Nerve injury can also be a cause of pain. 

Nerve injuries occur commonly in the setting of trauma. This can be work related, road traffic accidents and even self-inflicted. Nerve injury can also be secondary to other causes such as swellings, compression near the nerve etc. Nerve surgery seeks to restore the function of the nerve. Depending on the particular case, this may be achieved by various means like nerve repair, nerve grafts and nerve transfer. Because of our better understanding of the working of nerves and tissue healing, it is now possible to obtain better results than in the past. Nerves are peculiar in that they take a long time to grow. Hence, the results of the nerve take months to become apparent. 

What are the different techniques used to repair nerve injuries? 
These include the following:

1. Primary nerve approximation
2. Nerve grafting 
3. Nerve transfer
4. Nerve release
5. Decompression of compression neuropathy 

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Primary median nerve repair with end to end anastomosis of the radial artery.

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Deep laceration with transection of the ulnar nerve

Following repair of the ulnar nerve with cable grafts obtained from the sural nerve.

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Early postoperative picture which shows claw deformity

Late postoperative picture shows improvement of the claw defromity

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Spinal accessory to SSN (nerve transfer) for shoulder stabilization in C5-C6 injury

Oberlin plus nerve transfer for elbow flexion in C5-C6 injury

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