or nerve fibers, in the motor nerves are bigger, while the sensory nerve fibers are smaller," he said. "When the nerves are trying to regenerate using a motor nerve as a graft, it's easier for them to use the larger axons of another motor nerve, although the reason why is not clear."

The results could eventually translate into improved treatment for humans who have nerve damage from industrial, recreational or auto accidents.

"The research data is very compelling," Borschel said. "The evidence presented through this study could represent a paradigm shift from what we currently do in the operating room. The current standard of treatment for fixing a gap in a motor nerve is to use a sensory nerve, but we believe that if you use a motor nerve instead of a sensory nerve, then the outcome would be better."

The surgeons in the Division of Plastic and Reconstructive Surgery have begun using motor nerves grafts in limited patient cases with good results, Borschel said, but to clearly demonstrate the difference between motor nerve grafting and sensory nerve grafting in humans, much more study is needed.

One obstacle to the use of more motor nerve grafts is that the human body has a limited number of expendable motor nerves. Currently, surgeons are able to use the nerve from the gracilis muscle along the inner thigh or the latissimus dorsi along the side of the torso.

"This study, in conjunction with other related work from our laboratory, will likely result in a shift away from the use of traditional sensory nerve grafts to the much more permissive motor nerve grafts for reconstruction of injury," said Susan E. Mackinnon, M.D., the Sydney M., Jr. and Robert H. Shoenberg Professor and Head of the Division of Plastic and Reconstructive Surgery at the School of Medicine.

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Contact: Beth Miller
millerbe@wustl.edu
314-286-0119
Washington University School of Medicine
11-May-2007

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