SPECIAL FOCUS: Hand and WristNerve injury and repairSchmid, Daniel Ba; Salyapongse, A NeilbAuthor Information aResident Division of Plastic Surgery, USA bAssistant Professor, Plastic & Orthopedic Surgery, University of Wisconsin, Madison, Wisconsin, USA Correspondence to A. Neil Salyapongse, University of Wisconsin Plastic & Orthopedic Surgery, 1 South Park St. Madison, WI 53715, USA Tel: +1 608 287 2700; e-mail: firstname.lastname@example.org Current Orthopaedic Practice: September 2008 - Volume 19 - Issue 5 - p 475-480 doi: 10.1097/BCO.0b013e3283021495 Buy Metrics Abstract Purpose of review Nerve injury remains a common source of permanent patient morbidity. The treatment of these injuries and the loss of function result in a high cost to society. As our understanding of the cellular and molecular mechanisms underlying nerve regeneration continues to improve, advances in tissue engineering and gene therapy are providing new tools to treat nerve injuries. Refinements and variations on traditional repair techniques also are expanding the surgical options for treating these patients. This review discusses some of the most exciting developments that either currently are or soon may have clinical application. Recent findings From a technical standpoint, most of the advances center around the evolution of conduits. The increasing availability of synthetic conduits and innovative use of biologic conduits or blended biosynthetic conduits hold promise for improved regeneration and decreased morbidity. Cytokines and pathways critical to nerve regeneration are increasingly better defined; gene therapy promises the ability to modify these pathways and improve the outcomes. Summary Although the most promising results are from animal studies, a glance through any hand surgery journal will reveal the plethora of available conduits and the incorporation of materials and techniques adapted from these studies. Other advances such as gene therapy, await translation into the clinic. © 2008 Lippincott Williams & Wilkins, Inc.