Nerve Repair and Reconstruction Surgery in Gurugram

When Is Nerve Surgery Needed?

Nerve injuries in the hand and upper limb arise from a wide range of causes. Surgery is recommended when there is no spontaneous recovery or when the extent of the injury prevents natural healing.

• Sharp lacerations to the palm, wrist or forearm that divide a digital, median, ulnar or radial nerve
• Crush injuries from machinery, road traffic accidents or heavy falling objects
• Stretch (traction) injuries such as those seen in brachial plexus trauma from motorbike accidents
• Nerve damage from fractures or joint dislocations where a bone fragment injures an adjacent nerve
• Nerve tumours (neuromas) causing chronic burning pain that fail non-surgical management
• Failed previous nerve repair with ongoing or recurring numbness and weakness
• Nerve compression that has progressed to muscle wasting and requires surgical decompression combined with neurolysis

Dr. Yadav performs a thorough clinical examination supplemented by nerve conduction studies and electromyography (EMG) to map the injury accurately before planning the operative approach.

How Is the Surgery Performed?

All nerve surgery is performed under general or regional anaesthesia using tourniquet control to provide a bloodless field. An operating microscope providing 10–25× magnification is employed for all critical suturing steps.

• Direct (Primary) Repair: When the nerve ends can be approximated without tension — typically within 72 hours of a clean laceration — the two ends are sutured together with 8-0 or 9-0 nylon under the microscope. Even a small amount of tension at the repair site dramatically worsens outcomes, so this approach is only used when the gap is minimal.
• Nerve Grafting: When a gap of more than 1–2 cm exists, a cable graft from a donor nerve (commonly the sural nerve in the leg or the medial cutaneous nerve of the forearm) is harvested and interposed between the two ends. The graft provides a scaffold along which regenerating fibres can travel.
• Nerve Transfer: For proximal injuries, such as brachial plexus avulsions, where regenerating fibres must travel great distances, a nearby healthy nerve of lesser importance is re-routed to reinnervate a critical muscle. Common donor nerves include intercostals, the phrenic nerve, and fascicles from adjacent functioning nerves.
• Conduit Repair: For short gaps in digital nerves, biodegradable or collagen conduits can bridge the defect without the need for a donor site harvest.
• Neurolysis: Where the nerve is intact but encased in scar tissue following previous injury or surgery, internal or external neurolysis releases the nerve from its constricting sheath.

What to Expect During Recovery?

Nerve regeneration follows biological laws that cannot be rushed. Understanding the timeline helps patients set realistic expectations and stay motivated throughout what can be a lengthy rehabilitation process.

• Peripheral nerves regrow at approximately 1 mm per day — roughly 2.5–3 cm per month
• Early sensation and tingling (Tinel's sign) advancing along the nerve path is a positive sign of regeneration
• Sensory recovery generally precedes motor recovery and is more predictable
• Full recovery may take 6–18 months depending on the level of injury and the distance from the repair to the target muscle
• The operated limb is immobilised in a protective splint for 3–4 weeks to prevent tension on the repair
• Graded hand therapy begins from week 4 — initially gentle passive mobilisation, then active movement, sensory re-education and finally strengthening
• Sensory re-education programmes using textures and shapes are essential to help the brain re-interpret nerve signals as they return
• Patients younger than 35 years, those with distal injuries, and those repaired within 48 hours achieve the best results

Regular follow-up appointments every 4–6 weeks allow Dr. Yadav to monitor recovery with clinical and electrodiagnostic assessments and to adjust rehabilitation accordingly.

Why Choose Dr. Sunil Kumar Yadav?

Peripheral nerve surgery demands a surgeon who combines deep anatomical knowledge with the technical precision of microsurgery and the patience to manage long-term follow-up. Dr. Yadav offers all of these qualities in a dedicated subspecialty practice focused exclusively on the hand and upper limb.

• The only dedicated Hand & Microsurgeon serving Delhi NCR, with subspecialty microsurgical fellowship training
• Experienced in the full spectrum of nerve injuries — from simple digital nerve lacerations to complex brachial plexus reconstructions
• Performs all repairs under high-power operating microscope magnification for the finest possible suture technique
• Close collaboration with hand therapists specialising in sensory re-education and nerve injury rehabilitation
• Transparent, patient-centred consultations explaining realistic outcomes at each stage of recovery
• Located in Gurugram with easy access for patients across Delhi NCR, Faridabad, Noida and surrounding regions