Abstract
Cable nerve grafting is the recommended surgical treatment for large peripheral nerve
defects. Traditionally, this is performed by bridging a gap in the nerve with multiple
autologous nerve cables, repairing the epineurium of each cable to the perineurium
of a fascicle of the injured nerve that is similar in size to the graft. The authors
present a new technique in which they used nerve-cutting guides to aid in the placement
of fibrin glue to secure the sides of the cabled nerve graft together to facilitate
handling of the cabled nerve graft and to expedite repair. Freshening the graft nerve
ends after the application of fibrin glue using appropriately sized nerve-cutting
guides allows for donor-recipient size match and epineurium-to-epineurium repair of
the cabled graft to injured nerve. Though further follow-up is needed to determine
long-term outcomes following this technique, early results are promising with clinical
improvement seen in a similar timeframe to traditional grafting.
Keywords
cable nerve grafting - fibrin glue - nerve-cutting guide
