Median nerve reconstruction using autologous skeletal muscle vein-combined composite graft

Title: Median nerve reconstruction using autologous skeletal muscle vein-combined composite graft
Authors: M.B. Măciuceanu Zărnescu, D. Cinteză, I. Perşinaru, Ş.A. Popescu, I. Lascăr

The aim of this paper is to promote an alternative method regarding peripheral nerve reconstruction
using muscular-venous composite autograft harvested from the injured site.
Material and method
The chosen case regards a patient that suffered an injury situated on the volar side of the distal 1/3
of the left forearm with median nerve section, the etiology of the trauma (cutting angle cutting tools) being
very common within our clinic. The reconstruction of the subsequent median nerve gap was performed using
group fascicular sutures, two musculo-venous grafts being needed.
The clinical recovery of the patient was favorable both immediate postoperative, without any local
complications due to reconstructive microsurgery and to harvesting of the composite autograft, and lately,
his follow-up taking place over a period of 5 months. The sensitivity and motility within the territory of the
grafted median nerve have been developed within the same normal recovery rates for this type of lesion as
those obtained using the clasical method.
The reconstruction of the median nerve gap using composite musculo-venous autograft is a viable
alternative treatment method as long as the appropriate conditions are met. These are represented by the nerve
gap length of approximately 3 cm that cannot be repaired using the classical method and the refusal of the
patient as far as nerve harvesting from specific areas according to the chosen surgical method is concerned.
The local and general complications and the donor area’s comorbidity are minimal, being easily accepted by
the patient.

Keywords: nerve reconstruction, median nerv gap, muscular-venous graft.