Free nerve transplants in the reconstruction of secondary defects of the peripheral nerves of the hand

BACKGROUND: Peripheral nerve of the hand significantly participate ub the physiological functions of the hand. A defect in the area of the peripheral nerve therefore represents a problem, the solution of which is in the field of microsurgical reconstruction. The study deals with the possibility of microsurgical reconstruction by use of free nerve draft. SUBJECTIVE: Clinical observation of patients after microsurgical reconstruction of the hand peripheral nerve defect. MATERIAL AND METHODS: 34 patients after lesions of the median nerve, ulnar nerve and mutual impairment of both nerves. The evaluation according the known and spread system system of Medical Research Council, Seddon 1954. RESULTS: We have achieved very good results after isolated lesions of the median nerve, while the results in this, as well a in other groups are better in younger patients and in patients, in whom the devastation of tissue was not too great. Standard results were achieved in the group with isolated injury of the ulnar nerve and the worst results in a small group of concommitant impairment of both median and ulnar nerves. CONCLUSIONS: The results indicate that this method is unambiquously appropriate in such a complicated clinical picture. Our results are in accord with the data from other literature sources. MEANING FOR PRACTICE: Inevitability of specialized centres which would deal with this problem thus reducing the necessity of secondary reconstruction operations and naturally the reduction of financial expenditure or social support provision.