End-to-side neurorraphy as a salvage procedure for irrepairable nerve injuries: the results of three cases with revievv of the pertinent literatüre

Purpose: After a few reports on end-to-side nerve repair at the beginning of this century, the technique was put aside until it has recently been reintroduced by Viterbo. VVe herein present the results of three cases treated by end-to-side median-to-ulnar neurorraphy. Methods: Three patients vvith median nerve defects betvveen 15 and 22cm were treated by end-to-side nerve repair, through an epineurial window. The follow-up times were betvveen 12 and 18 months. Sensory evaluation involved superficial touch, pin-prick, and two poi'nt discrimination tests. Motor evaluation was done by assessing the presence of opposition, and palpating the abductor pollicis brevis. Results: Sensory recovery was observed in ali the patients, in the median nerve dermatome. İn case-3 it was incomplete at the tips of his fingers. Motor recovery vvas absent, except in case-1, who could perform opposition before the operation, as well. Conclusions: End-to-side nerve repair is a viable alternative in cases vvith long gaps betvveen the ends of the injured nerve.