Table of Contents
ISRN Surgery
Volume 2011, Article ID 120367, 2 pages
http://dx.doi.org/10.5402/2011/120367
Case Report

Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

1Department of Neurological Surgery, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR 97239, USA
2Department of Reconstructive Surgery, Mike O’Callaghan Federal Hospital, Nellis Air Force Base, NV 89191, USA
3Division of Trauma and Surgical Critical Care, University of South Alabama College of Medicine, Mobile, AL 36688-0002, USA

Received 16 February 2011; Accepted 12 March 2011

Academic Editors: C. C. Chuang, M. J. Hershman, and A. Nissan

Copyright © 2011 Brian T. Ragel et al. 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

Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity injuries. Bilateral above-the-knee amputations (AKAs) and exploration of the medial shrapnel wound were undertaken. A 7 cm traumatic defect in the median nerve was repaired with interpositional sciatic nerve graft harvested from the AKA. Conclusion. Recovery of motor function after nerve grafting is dependent on motor axons reinnervating target muscles, making proximal nerve injuries problematic. We identify a potential nerve harvest site in patients with lower extremity amputations in need of long segment nerve repairs.