The Ochiai technique for peripheral nerve grafting in the upper limb

The Ochiai technique for brachial plexus neurotisation consists in donor intercostal nerves coaptation through an epineural cuff in order to avoid any axonal loss. We extrapolate this technique to peripheral nerve grafting to direct all regenerating axons through the grafts up to their end, especially for the grafts repairing the functionally most important fascicular groups. When the graft's diameter is lower than the recipient nerve, the epinerve can be tailored as a flap to wrap the grafts. We used this technique in 5 brachial plexus neurotisations with intercostal nerves, and to 11 peripheral nerve grafts: 8 ulnar, 2 median and one radial nerves. For the ulnar and radial nerves, the motor fascicular groups are the most important, as is the sensitive ones for the median nerve. The two year results indicates an improuvement in restoring function in comparison with standard grafting.