An overture to basic science aspects of nerve injuries

J Hand Surg Eur Vol. 2011 Nov;36(9):726-9. doi: 10.1177/1753193411422329. Epub 2011 Sep 13.

Abstract

Does the lack of improvement in surgical treatment of nerve injury despite thousands of years of research disturb you? Do you think that basic science has not really contributed to any advancement in the treatment of nerve injury? Have you contributed? Do you think that new molecular biology knowledge in nerve injury and repair is important? Knowing from basic science that the immature nervous system is more fragile would you agree with the view that to be 'aggressive' in surgery of the newborn with a brachial plexus injury could be unscrupulous? As molecular biology of the nervous system has demonstrated that the best conditions for regeneration occur immediately after an injury do you find the approach of postponing surgery until at least 3 months after a closed nerve injury to be ignorant and even negligent? Taking into account the normal occurrence of inhibitory molecules in the uninjured peripheral nerve do you think that functional improvement from end to side nerve repair is a myth? Are the recent attempts to artificially enhance nerve regeneration for instance in synthetical conduits like nature seen 'through a glass darkly'? Do you agree that new concepts in surgical treatment of nerve injury are timely? Do you have the time?

Publication types

  • Review

MeSH terms

  • Cell Adhesion Molecules, Neuronal / metabolism
  • Chemotactic Factors / metabolism
  • Cicatrix / pathology
  • Down-Regulation
  • Fibrosis
  • Humans
  • Microsurgery
  • Nerve Degeneration
  • Nerve Growth Factors / metabolism
  • Nerve Regeneration
  • Neurons / metabolism
  • Neurons / pathology
  • Neurosurgical Procedures
  • Peripheral Nerve Injuries / pathology
  • Peripheral Nerve Injuries / physiopathology*
  • Peripheral Nerve Injuries / surgery
  • Recovery of Function
  • Up-Regulation

Substances

  • Cell Adhesion Molecules, Neuronal
  • Chemotactic Factors
  • Nerve Growth Factors