When a nerve is damage some muscle loss their function, to regain function those muscles need to be resupplied by the nerve with in a year, if patient come after several months of injury, it is expected that after nerve repair it will take longer than one year to reach muscle, in that case your surgeon may consider supplying paralyzed muscle with some other closeby nerve which took shorter time to reach the muscle and that muscle will start functioning.

During nerve transfers your surgeon will only take a nerve of minimal significance of a part of the nerve so that the function supplied by the donor nerve remains intact. For example,there are many nerves in the chest for breathing, if few breathing nerves are used to restore elbow flexion, the patient may initially have to take a deep breath to move the arm. The brain then learns this trick and soon the patient is able to move the arm simply by thinking about moving the arm. Motor nerves are used to re-innervate muscles and sensory nerves are utilized to restore sensation. This technique provides a nearby source of nerve for faster recovery.

Your surgeon will take complete history and examination to determine availability of donor nerves. He may also order a few tests like NCS and EMG to determine the health of muscle and availability of donor nerves. This surgery is performed under general anesthesia and there could be single or multiple cuts on the area being operated which will be closed with sutures. A plaster for a few weeks will be applied till the nerve ends heals. After that you will need physiotherapy and in some cases use of a machine which gives small currents and keeps your muscles in good shape till the nerve reaches and starts functioning.

Almost full function with reduced power is generally expected after few months 

FAQS

1. Can this procedure be done after a few years?

Principally the nerve should reach to muscle within one year unorder to restore function, with delay of more than a year will lead to muscle death and no return of function, but sensory transfers can be done after many years.

2. Will I lose function of the donor nerve?

Yes. But your surgeon will plan it in a way that you will lose the most insignificant function to gain what is required.

3. How long will recovery take?

Recovery from nerve transfer surgery will take somewhere between 6 months to about a year depending on the procedure, Sensory recovery may take even longer.

4. Are there any medications to increase the growth of nerves?

Some vitamins are required for the growth of nerves, it’s better to take multivitamins and a healthy diet.

 

Written by :  Dr. Obaidur Rahman

Copyrights: Pakistan association of Plastic Surgeons