Principles of Peripheral Nerve Surgery

Abstract

The loss of afferent and efferent signal transduction following traumatic peripheral nerve injury has immediate and long-term effects on target organs (e.g., muscles and sensory receptors) as well as somatosensory and motor brain areas. The goal of surgical peripheral nerve repair is to mitigate these negative outcomes by restoring the continuity of the damaged peripheral nerve to allow axonal regeneration and reinnervation of target tissues. A complete understanding of the organizational complexity of peripheral nerve architecture reveals that a peripheral nerve is more than just a “cable” connecting central neurons to peripheral end organs. The outcome of nerve repair depends on many factors, not only at the site of injury but also in the central nervous system, which can undergo functional cortical reorganization in response to post-injury axonal outgrowth.