Nerve repair after loss of motor function and sensibility of the upper extremity

Nerve injuries in the upper extremity after trauma or tumor resection can result in severe disability. Patients are usually adults with a high activity level, so these injuries not only impact their quality of life but also significantly affect their professional reintegration. In the past three decades, progress in micro-surgical techniques and instruments has resulted in improved outcomes for nerve injuries. if the prognosis for nerve repair is reasonably good, it is usually preferred over tendon or flap transfer procedures. However, lesions of peripheral nerves, such as a high radial nerve palsy, may still yield unsatisfactory results. The prognosis also depends on the patient's age, as the regenerative process is delayed in older patients. Tendon or flap transfers to restore sensation can be performed at any time posttrauma. These procedures abbreviate the time when hand function is severely impaired so that the patient has alternatives to persistent nerve palsy with the necessity for permanent external splints. This paper gives an overview of the most common procedures for restoring hand function and sensation in the most important digits, and it provides help for decision making.