We acertained the sural nerve was nourished by the cutaneous branches of the peroneal artery or the muscular perforating branch of the posterior tibial artery and developed the new free vascularized sural nerve graft. Twenty-one clinical cases including four brachial plexuses, six median nerves, four ulnar nerves, five digital nerves and two radial nerves were reconstructed with this technique. Their graft length was between 6 and 30cm. Most of the grafts were sected and folded on itself without damage to the blood supply of the nerve and used in the fashion of cable graft.
Their follow-up period ranges from 2 to 32 months. An early and sufficient functional recovery is obtained though the final extent of recovery in half of our cases could require several months.
Compared with the other vascularized nerve graft and conventional nerve graft, our method has many advantages: 1) A “cable graft” can be designed on itself without damage to blood supply of the nerve, 2) Survival of the nerve can be reasoned by the accompanying flap and the flap can close the skin defect simultaneously, 3) An early and certain functional recovery can be obtained in the poorly conditioned cases.
