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

Abstract

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.