Microsurgical techniques to reconstruct irreparable nerve loss.

Sophisticated procedures are now available to replace both sensory and motor loss. These are all possible through the advances in microsurgical techniques. The renewed interest in nerve repair and nerve grafting has been discussed. Improved results are now obtainable because of microsurgery. Standard neurovascular island flaps are being modified and superseded by neurovascular free flaps, with their improved sensation and accurate cortical representation. Examples of free tissue transfers that provide not only cover and sensation but structure, function, and innervated muscle have been illustrated. Microsurgical nerve grafting and transplantation are only in their infancy. New flaps and techniques await discovery and application.