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Repair of multiple peripheral nerve injuries in the arm; temporary bone shortening using the external fixator followed by physiologic length restoration

Chol-Ryong Pak, Myong-Guk Jang, Song-Gun Ri, Su-Ryon Ryang, Un-Hui Jong, Won Kim


Purpose: The purpose of this study is to present the outcome for multiple peripheral nerve injuries with large defect by end to end repair of proximal and distal nerve stumps while ensuring the physiologic length of the bone by an external fixator. Methods: Fractured humeral proximal and distal stumps were overlapped as many length as the nerve gap and fixed using the external fixator, and the proximal and distal nerve ends were approximated and the repair was performed under the operating microscope. Bone stumps were lengthened 1 mm per day using the external fixator to compensate physiologic length of the arm after 4 weeks of the nerve repair. Results: Of 13 patients, sensitivity function was S3-S4 in 11 patients, S2 in 2 patients and motor function was M4 or M5 in 12 patients, M3 in 1 patient. In all patients the physiological length of the arm was restored and the bone stumps were reduced and united in situ after the operation. Conclusions: We obtained good recovery result for multiple peripheral nerves with large defect by end to end repair of proximal and distal nerve stumps without sacrifice of the donor nerve and later restored the physiologic length of the arm using the external fixator.


Nerve gaps; Nerve repair; Bone shortening; External fixator

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