Metabolic factors in surgery of peripheral nerves.

Respect for the metabolic changes within the neuron is critical in planning peripheral nerve surgery. Only by understanding the different metabolic responses of the nerve tissue and the supportive tissue can anastomosis be planned where the budding neuron stands its best chance of successfully regenerating across a repair site. Often, a short delay in nerve repair is indicated. With all factors ideal, good motor function can be counted on across one joint from the next group of muscles. Rarely is there good function across two joints. Protective sensory function can be achieved distally even under the most adverse metabolic conditions because of the independent metabolic state of these end organs.