History of Peripheral Nerve Surgery Techniques

Abstract

The nineteenth century witnessed significant discoveries in the understanding of the peripheral nerve response to injury. Unfortunately, these discoveries were not widely accepted and several physiologically implausible nerve repair procedures survived into the first decades of the twentieth century. The surgical experience in World War I winnowed out most of these unsound techniques and laid the foundations for modern direct nerve repair. The surgical experience of World War II led to a rational classification of nerve injuries and refined the timing for surgical intervention. Major postwar developments that led to the modern era include improved nerve grafting techniques, intraoperative nerve action potential recording, and strategies for the repair of brachial plexus lesions.