Acute Reconstruction of Traumatic Injuries of Median and Ulnar Nerves by Grafting with Intercostal Nerves from the Rectus Muscle: Case Reports

ABSTRACT

In two cases of complicated hand and wrist injuries for which rectus flaps were used as soft-tissue coverage, intercostal nerves from the rectus muscles were harvested simultaneously to graft significant nerve defects. In one patient, a 7-cm ulnar-nerve defect was bridged with four intercostal nerves. The other patient had a 5-cm median-nerve defect repaired with three intercostal nerves. Both patients recovered either protective or normal sensation; and the patient with the median nerve injury recovered thenar muscle function. Intercostal nerves harvested with rectus muscle flaps can be the basis for acute grafting of nerve defects without using conventional nerve grafts at a traumatic site.