Reconstruction of chronic nerve injuries using artificial nerve conduits:A case seriesOA

Traumatic peripheral nerve injuries are a major contributor to long-term disability,accounting for nearly half of all peripheral nervous system disorders.Although autologous nerve grafting remains the clinical gold standard,it is limited by donor-site morbidity and often fails to achieve full functional recovery.Biodegradable collagen conduits have emerged as an appealing alternative,providing a scaffold for directed axonal growth without requiring graft harvest.We reported three cases of chronic nerve injuries(6-12 months post-trauma):two involving 2.0-3.5 cm ulnar nerve defects in the forearm and one with a 2.5 cm median nerve defect at the wrist.Under microscopic guidance,each defect was bridged with a tubular type I collagen conduit secured by epineurial sutures,followed by standardized physiotherapy and sensory reeducation.At 12-18 months of follow-up,all patients demonstrated near-complete sensory recovery—two-point discrimination and Semmes-Weinstein thresholds returned to≤6 mm—and motor function improved to Medical Research Council grades 4-5,restoring fine dexterity and grip strength.Patient-reported measures indicated marked reductions in neuropathic pain and paresthesia.No conduit-related adverse events or neuroma formation were observed.This case series highlights the potential of collagen-based conduits to promote robust axonal regeneration and functional restoration even in delayed presentations.By eliminating donor-site morbidity and simplifying the reconstructive procedure,conduit-assisted repair offers a less invasive,reproducible alternative to autologous grafts for both acute and chronic peripheral nerve injuries.