Reconstruction of the human median nerve in the forearm with the Neurotube.

Abstract

Reconstruction of the median nerve in the forearm traditionally has required multiple interfascicular interposition autologous nerve grafts. Recovery of two-point discrimination, even in young adults, has been reported rarely. Two patients, aged 43 and 61, are reported with 5-year follow-up of median nerve reconstruction in the distal forearm in which multiple interposition bioabsorbable polyglycolic acid conduits (Neurotube) were used to bridge the 3-cm nerve defects. Four separate 2.3-mm diameter, 4.0-cm long conduits were used in each patient. Sensory re-education was used for rehabilitation. Each patient recovered two-point discrimination with good localization in the thumb, index, and middle finger by 2 years after the nerve reconstruction. Both patients recovered abductor pollicis brevis function.