The role of interfascicular nerve grafting after gunshot wounds. A report of 44 cases

• Published in: International orthopaedics Vol. 20; no. 2; p. 87
• Main Authors: Stancić, M F, Eskinja, N, Bellinzona, M, Mićović, V, Stosić, A, Tomljanović, Z
• Format: Journal Article
• Language: English
• Published: Germany 1996
• Subjects: Adolescent; Adult; Child; Croatia; Graft Survival; Humans; Microsurgery; Middle Aged; Peripheral Nerve Injuries; Peripheral Nerves - transplantation; Prognosis; Transplantation, Autologous; Treatment Outcome; Warfare; Wounds, Gunshot - etiology; Wounds, Gunshot - surgery; Croatia
• ISSN: 0341-2695
• DOI: 10.1007/s002640050036

In this study the authors present the results of 44 patients with 49 interfascicular nerve grafting procedures necessitated by gunshot wounds. The aim was to establish the effectiveness of microsurgical interfascicular nerve grafting for war injuries. The 49 interfascicular nerve grafting procedures were performed between July 1991 and January 1993. All but one were performed within 6 months of injury. Nerve recovery was assessed independently by a neurologist. The M/S scale was used for median, ulnar and radial nerves, and the grading scale recommended by Millesi was used for the sciatic, tibial and peroneal nerves. Follow-up was for between 2.5 and 3.5 years. Patients scoring at least M3/S3+, or Grade 2 on the Millesi scale, were considered to have useful functional recovery which occurred in high median (0 out of 1), low median (4 out of 9), high ulnar (0 out of 2), low ulnar (5 out of 11), high radial (4 out of 6), low radial (2 out of 2), sciatic (5 out of 9), peroneal (4 out of 7), and tibial (2 out of 2). The extent of recovery correlated inversely with the patient's age and the length of the graft, but was independent of the time between injury and surgery and of presumed projectile energy. Our results suggest that microsurgical interfascicular nerve grafting is of value in the management of wartime nerve injuries.