What is Nerve Repair?

Nerve repair is a microsurgical procedure performed to reconnect or reconstruct a damaged peripheral nerve, restoring its ability to transmit signals between the brain and the body. Injuries to nerves in the hand, wrist, or forearm can result from trauma, lacerations, or surgical complications, leading to numbness, weakness, or loss of function.

At Katranji Hand Center, nerve repair is performed with high-precision microsurgical techniques to optimize recovery of sensation and movement, often under magnification using specialized instruments.

Causes

Nerve repair may be required for:

• Traumatic lacerations from cuts, glass, or machinery

• Crush injuries affecting nerve continuity

• Stretch or traction injuries

• Nerve entrapments (e.g., carpal or cubital tunnel) with permanent damage

• Nerve damage during surgery

• Chronic compression resulting in axonal degeneration

Signs & Symptoms

Symptoms of nerve injury that may require repair:

• Numbness or tingling in a specific nerve distribution

• Loss of motor function (e.g., inability to move fingers or wrist)

• Muscle wasting over time

• Pain, burning, or electric shock-like sensations

• Poor coordination or grip strength

• No improvement with conservative treatment

Diagnosis

At Katranji Hand Center, nerve injury evaluation includes:

• Detailed neurological examination – assessing sensory and motor function

• Tinel’s sign – tapping over the nerve to elicit tingling

• Two-point discrimination testing

• Nerve conduction studies (NCS) and electromyography (EMG) – to measure nerve activity and muscle response

• Ultrasound or MRI – in complex or deep injuries

Treatment Options

Non-Surgical

• Observation and therapy – for minor nerve contusions or partial injuries

• Splinting – to protect weak muscles and prevent contractures

• Steroids or medications – for inflammation or neuropathic pain

Surgical Nerve Repair

Performed when there is complete nerve transection or when function fails to recover with conservative management.

Types include:

• Direct End-to-End Repair – if the nerve ends can be reconnected without tension

• Nerve Grafting – using a donor nerve (usually from the leg) to bridge a gap

• Conduits or Nerve Wraps – synthetic or biologic tubes guiding regrowth over small gaps

• Neurolysis – removing scar tissue surrounding the nerve if compression is the issue

Postoperative Care

• Immobilization in a protective splint

• Pain management and wound care

• Early referral to hand therapy for desensitization, sensory re-education, and motor retraining

• Nerve regeneration rate: ~1 mm/day, so full recovery may take months to over a year

Associated Risks

• Incomplete recovery of motor or sensory function

• Pain or neuroma (painful nerve scar)

• Muscle atrophy (if motor function isn’t restored)

• Scar sensitivity

• Repeat surgery in severe or failed cases

Prognosis

The outcome of nerve repair depends on:

• Type of injury

• Location (closer to the hand = faster recovery)

• Time to surgery

• Age and overall health

At Katranji Hand Center, timely intervention and advanced microsurgical techniques significantly improve the chances of restoring function and minimizing permanent damage. Recovery requires patience, ongoing therapy, and close follow-up.