Neuroma-in-Continuity after open CTR micro-repair
Three forms of peripheral nerve injuries have been described. Neuropracxia the mildest form, is often incomplete and produces a transient loss of function. Its key feature is spontaneous recovery that occurs within hours to several months of injury. Axonotemesis, refers to a complete interruption of the axon and myelin sheath while preserving the endoneurial core connective tissue structure of the nerve. Often described as a “neuroma-in-continuity,” this type of injury results in an immediate loss of motor, sensory, and autonomic function distal to the lesion. Spontaneous recovery can occur but requires more time than a neurapraxic injury and depends on a number of factors that affect the rate of nerve regeneration. The final type of injury, neurotmesis, implies a complete disruption of both the neural and connective tissue elements of a peripheral nerve. This type of injury is incompatible with spontaneous recovery and will ultimately require surgical intervention if any function is to be regained.