Shouldn’t the broken nerve endings or the muscle fibres not meld together? How do doctors reconnect those?
In: Biology
As you said, control depends on nerves. Blood vessels are VERY different from nerves. A vessel is simply a hollow tube which can easily be reconnected (called an anastomosis) to restore bloodflow and save the limb and if necessary a synthetic or even human tissue graft can be included if more length is needed. Nerves, on the other hand (no pun) are more like fiber optic cables. They contain a bunch of individual miniscule fibers that have to naturally reattach to regain function. In the case of a larger nerve it’s relatively easy to sew the two ends together but that doesn’t mean the individual fibers will find their mate and reattach correctly. Couple this with the fact that nerve regeneration is a VERY slow process and the final outcome is a crapshoot. Microsurgery has made it much easier to approximate them so it’s much more possible than in the past to regain function.
The hand is special in that almost all of the muscles to control hand and finger movement are in the forearm, not the hand itself. So, if you reattach the tendons coming from those muscles, the hand can still move. Sensory nerves are another issue. The nerves can be reattached, but it can take a long time, if ever, for the actual nerve fiber connections to grow back, so usually the reattached part is numb. It is actually the outside of the nerve that is sutured together. All attachments are done with very thin suture, and often require looking through microscopes to do the operation
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