Methods: Clinical and electrophysiological motor function data were compared before and after microsurgical nerve grafts reconstruction of complete peripheral nerve injury. Forty-five patients totaling 48 injured nerves were treated by interfascicular nerve grafts. Microsurgery was performed 1 month to 1 year after injury (Group 1, 29 patients,) and 1 year to 5 years after injury (Group 2, 19 patients). Five nerves were reconstructed by grafts of <2cm long, twenty nine nerves by grafts of 2 to 5 cm long, eleven nerves by 5 to 10cm long grafts and three nerves by grafts of >10cm long. Follow up after the operation was from 1.5 years to 5 years.

Results: Statistically significant improvement in muscle strength occurred after nerve grafts reconstruction, compared to before repair (p<0.001). Intraoperative and postoperative electrophysiological analysis showed statistically significant improvement in amplitude of compound muscle action potentials (p<0.001) and recruitment (p=0.002) compared to before surgery. Timing of Surgery: No statistically significant difference in muscle strength occurred between groups after surgery, each showing statistically significant improvement, Group 1 (p<0.001), Group 2 (p<0.001).

Conclusion: Interfascicular nerve grafts reconstruction can progressively improve nerve function in peripheral nerve injuries, leading to significant functional recovery, even when microsurgery performed one year or later after the injury.