Direct muscular neurotization.

Direct muscular neurotization has limited indications: loss of the distal stump of a motor nerve or avulsion of the "neural" part of one or more muscles. These lesions cannot be repaired with conventional microsurgery techniques, and without the presented technique, the denervated muscles will remain permanently paralyzed. Despite rare failures from poor local vascular or muscular conditions, direct muscular neurotization has provided the vast majority of good results, with scores similar to those obtained with good microsurgical sutures or grafts and has been adopted by several microsurgeons.