Nerve repair is microsurgery that rejoins the cut ends of a nerve under an operating microscope; nerve grafting bridges a gap with a donor nerve when the ends cannot meet. They help people whose nerves have been cut, crushed or stretched, causing numbness, weakness or paralysis, and are unlikely to recover on their own.
- AnaesthesiaRegional (arm block) or general
- DurationTypically 1 to 3 hours
- Hospital stayDay care to 1 to 2 days
- Back to routineSplint for 2 weeks or more; nerve recovery over months
What is nerve repair and nerve grafting?
Nerves carry sensory and motor signals between the brain and the body. An injured nerve can cause loss of sensation, muscle paralysis or pain. Treatment depends on the nerve's location and the severity of the injury.
In nerve repair, the surgeon reconnects the two nerve ends with microsutures under an operating microscope; this works when the ends can be brought together without tension. The most common method is epineural repair, with stitches placed through the nerve's outer sheath (epineurium); the number of stitches depends on the nerve's diameter.
When a segment of nerve is lost, nerve grafting uses a piece of a less important nerve, usually the sural nerve from the leg or the medial antebrachial cutaneous nerve from the arm, to bridge the gap so that nerve fibres can regrow across it. Nerves regenerate slowly, roughly 1 mm per day, so recovery takes months.
Who is nerve repair and nerve grafting for?
- Nerves cut by glass, knives or machinery (lacerations)
- Severe stretch injuries
- Focal contusion, such as gunshot wounds
- Nerves severely compressed by fracture fragments
- Drug injection injuries and electrical burns with nerve damage
How is it done?
- Performed under anaesthesia with an operating microscope
- Damaged nerve ends are trimmed back to healthy tissue
- Epineural repair: fine sutures through the outer sheath rejoin the ends without tension
- Nerve grafting: a donor nerve (typically sural or medial antebrachial cutaneous) bridges any gap, leaving a scar and a small area of numbness at the donor site
- Before planned surgery: stop aspirin-type medicines if advised and avoid smoking and alcohol for at least two weeks
What is recovery like?
- The area is splinted and immobilised for at least 10 to 14 days
- After motor nerve repair, gentle movement may be advised to prevent stiffness
- After sensory nerve repair, protect the numb area from very hot, very cold or sharp objects
- Once healed, massage the scar with a bland cream at least three times a day for about three months
- Nerve regrowth is roughly 1 mm per day, so full recovery typically takes several months or longer
What are the risks?
- Pain, infection, bleeding or delayed healing at the repair or donor site
- Incomplete recovery of sensation or strength
- Painful neuroma formation
- Numbness at the graft donor site
- Outcome depends on the type and level of injury, the repair method and the time since injury
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
How soon should a cut nerve be repaired?
As early as practical, ideally at the time of the initial wound care or within days, when the nerve ends are clean and easier to bring together. Delayed repair is still possible, but scarring and retraction of the ends may mean a nerve graft is needed and recovery may be less complete.
How long does nerve recovery take?
Nerves regrow at roughly 1 mm per day, so recovery depends on how far the regrowing fibres must travel. An injury in the finger may recover over a few months, while a nerve injury near the elbow or shoulder can take a year or more. Younger patients generally recover better.
What is a nerve graft and where is it taken from?
A nerve graft is a piece of a less important sensory nerve used to bridge a gap in an injured nerve. It is usually taken from the sural nerve at the back of the leg or a skin nerve in the forearm, leaving a scar and a small patch of numbness at the donor site.
Will I get full feeling back after nerve repair?
Not always. Many patients regain useful sensation and strength, but recovery is often incomplete. The result depends on the nerve involved, the level and type of injury, the time between injury and repair, the patient's age and adherence to therapy. Your surgeon will discuss realistic expectations.
