neurorrhaphie

Neurorrhaphie, also called neurorrhaphy, is a surgical repair of a damaged peripheral nerve in which the severed ends are realigned and sutured to restore continuity. It is performed after traumatic nerve transection or significant laceration, after excision of nerve tissue for tumor, or in the repair of nerve injuries during reconstructive procedures. The operation is conducted under high magnification using microsurgical techniques to align nerve fascicles and reapproximate the epineurium, usually without creating undue tension. Common methods include end-to-end epineurial neurorrhaphy, with or without fascicular alignment; for longer gaps, interpositional nerve grafts (often from the sural nerve) may be used to bridge the ends. The aim is to permit axonal regeneration from the proximal stump toward targets, acknowledging that precise fascicular matching improves functional recovery. Regeneration proceeds at about 1–3 mm per day, with the timeline and extent of recovery influenced by injury severity, distance to the target, and patient factors. Outcomes are variable: sensory nerves generally fare better than motor nerves, and function may recover partially or incompletely despite technically successful repair. Potential complications include scar tissue, misalignment of fibers, neuroma formation, and infection. When direct repair is not feasible, alternative strategies such as nerve grafts or nerve transfers can restore some function.