Landmark studies in nerve surgery

This chapter describes five landmark studies that have played a pivotal role in the conceptualization, investigation, and application of nerve transfers as a surgical technique aimed at restoring function following peripheral nerve injuries. • The first study explores the development of Green Fluorescent Protein (GFP) as a vital tool for neuronal labeling and tracking. GFP revolutionized the field by enabling researchers to visualize the regrowth and reinnervation of nerves during early animal models of distal nerve transfers, providing valuable insights into nerve regeneration and functional recovery. • The second study focuses on retrograde labeling techniques. The ability to map connections between distal nerves and proximal targets provided essential guidance to evaluating regeneration through nerve transfers. • The third study involves the quantification of functional motoneurons required for meaningful recovery. Identification that only 20% of motoneurons are necessary for motor function suggested that fascicles could be safely taken from healthy nerves and only a limited number of axons are required for target reinnervation. • The fourth study investigates the topographical arrangement of nerve fascicles, uncovering the intricate organization and connectivity within peripheral nerves. This knowledge facilitated precise targeting for identifying donor and recipient fascicles. • The final study explores the clinical translation of distal nerve transfers. By examining the outcomes of distal nerve transfer surgeries in a clinical setting, researchers provided valuable evidence of its efficacy and applicability in real-world scenarios. These five landmark studies paved the way for advanced surgical techniques, better patient outcomes, and the widespread adoption of nerve transfers as a valuable treatment modality.