[Results of great nerve trunk grafts].

The authors describe the results of 60 cases of trunk repairs, carried out by the same surgeon, and with a follow-up period of 18 months or more. The grafts were autologous and in most cases the donor was the saphenous nerve. The grafts were placed under microscope. The recipient sites were the median nerve (19 cases), the ulnar nerve (16 cases), the radial nerve (10 cases), the sciatic nerve (8 cases), the musculo-cutaneous nerve (6 cases) and the spinal nerves (1 case). After a description of the technique used, the results are analyzed in accordance with the classical criteria of Highet and Holmes, to which has been added the notion of harmony of movement. The overall evaluation has been carried out in accordance with the following scale: two-point discrimination less than 15 mm + M4 or M5 + harmony = very good; two-point discrimination impossible to interpret, protective sensitivity S2 + M4 or M5 + harmony - good; crude protective sensitivity (S1) + M3 or less X average. Of the 60 cases, 21 ranks as very good and 22 as good, together giving an aggregate 72% of the total, with 12 cases ranking as mediocre and 5 failures. The incidence on these results of the following factors in then considered: the patient's age, the nerve damaged, the level of the injury in a given nerve, the time intervening between the initial lesion and the repair, the length of the nerve injury, the number of fascicles, the quality of the tissues and the surgeon's experience. It would seem that the best chances of success involve: a patient aged under 30, a short intervening period (less than 6 months between accident and repair), an injury less than 5 cms long, the maximum number of fascicles, good quality tissues and an experienced surgeon.