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Funicular Orientation by Direct Stimulation AN AID TO PERIPHERAL NERVE REPAIR
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From the Plastic Surgery Services of St. Mary's Hospital and Hôpital St.-Luc, Montreal
1968 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1968 Sep 01;50(6):1178-1186
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A method of identifying funiculi in the cut ends of severed peripheral nerves has been tried and developed as a clinical experiment with nine patients having thirteen nerve lesions.

By weak electrical stimulation under microscopic control, predominantly motor funiculi are identified in the peripheral stump, and certain sensory localizations are made in the central stump. The identification procedure is performed with the patient conscious. This funicular-mapping procedure is performed in association with nerve repair by funicular anastomosis by means of microsurgical technique and instruments.

The purpose of developing such a technique is to increase the proportion of satisfactory nerve-fiber unions at the site of injury and to decrease the number of unsatisfactory terminations of downgrowing central fibers.

The results of this small series indicate a quantitative improvement over repairs done in the conventional manner by epineural suturing.

The technique is experimental. A larger series of cases followed over a longer period is necessary before the method can be recommended as an advantageous, routine procedure.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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