BioMed Research International
Volume 2014, Article ID 698256, 13 pages
http://dx.doi.org/10.1155/2014/698256
Peripheral Nerve Reconstruction after Injury: A Review of Clinical and Experimental Therapies
Plastic and Reconstructive Surgery Unit, St. Vincent’s Hospital, 41 Victoria Parade, Fitzroy, Melbourne, VIC 3065, Australia
Received 24 February 2014; Accepted 16 June 2014; Published 3 September 2014
Academic Editor: Mario I. Romero-Ortega
Copyright © 2014 D. Grinsell and C. P. Keating. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Unlike other tissues in the body, peripheral nerve regeneration is slow and usually incomplete. Less than half of patients who undergo nerve repair after injury regain good to excellent motor or sensory function and current surgical techniques are similar to those described by Sunderland more than 60 years ago. Our increasing knowledge about nerve physiology and regeneration far outweighs our surgical abilities to reconstruct damaged nerves and successfully regenerate motor and sensory function. It is technically possible to reconstruct nerves at the fascicular level but not at the level of individual axons. Recent surgical options including nerve transfers demonstrate promise in improving outcomes for proximal nerve injuries and experimental molecular and bioengineering strategies are being developed to overcome biological roadblocks limiting patient recovery.