Abstract
Peripheral nerve injuries require reconstruction when direct, tension-free repair is not possible. A range of reconstructive strategies are used to restore continuity and promote axonal regeneration, including graft-based reconstruction, nerve transfers, conduit-based repair, supercharged end-to-side augmentation, and emerging regenerative therapies. Autologous interfascicular nerve grafts and vascularized grafts remain established techniques, whereas processed nerve allografts provide a donor-sparing alternative. Nerve transfers are increasingly used for proximal injuries with long regeneration distances, and conduits are an option for gaps shorter than 5 mm. Nerve-wrapping techniques are used to reduce perineural scarring and preserve gliding in complex or revision cases. Emerging adjunctive therapies, including electrical stimulation, nerve fusion approaches, and exosome-based biologics, aim to enhance axonal growth and optimize the regenerative environment. This review summarizes current evidence for these approaches, focusing on indications, outcomes, and limitations of these techniques.
Recommended Citation
Skipp, Niklaus; Lana Dokic; Christina Wassef; Jazzlyn Gonzalez; Ana Love; Heather Mercer; and Deana Mercer. "Peripheral Nerve Repair and Reconstruction: Current Techniques, Adjuncts, and Emerging Therapies." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/6