{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:19:35Z","timestamp":1762528775637,"version":"build-2065373602"},"reference-count":91,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Non-transected and partially transected peripheral nerve injuries (neuromas-in-continuity) are relatively common but understudied. Their optimal surgical management and expected outcomes remain unclear. We conducted a literature review of surgical repairs in such lesions and illustrate a case to guide decision-making. Systematic searches of PubMed and Google Scholar identified 70 eligible reports (Level I = 2, Level II = 5, Level III = 37, Level IV = 20, Level V = 4). Across studies, neurolysis of NAP-positive lesions often restored antigravity strength, while direct repair or grafting of nonconductive segments yielded meaningful recovery in ~75%. After neurolysis or reconstruction, ~77\u201392% of brachial plexus\/axillary neuromas-in-continuity reached LSUHSC Grade \u22653. Median\/ulnar lesions treated with neurolysis, biologic\/vascularized coverage, or reconstruction showed reliable pain relief but variable sensory\/motor recovery. Radial\/PIN lesions improved in some series irrespective of NAPs. Earlier intervention, shorter gaps, distal sites, and younger age correlated with superior outcomes. Meanwhile, prolonged observation risking end-organ atrophy degraded results. Adjuncts such as electrical stimulation and wraps may aid reinnervation or reduce scarring, though high-quality evidence is limited. Conclusions: For non-transected and partially transected PNIs, a pragmatic approach emerges: Observe low-grade injuries with serial examinations. Explore early if recovery stalls (\u22483\u20136 months). Use NAP-guided neurolysis for conductive lesions. Perform tension-free repair or grafting for nonconductive segments, adding anti-adhesive coverage when appropriate. Standardized reporting and prospective trials are needed to refine timing, technique selection, and patient-reported outcomes.<\/jats:p>","DOI":"10.3390\/brainsci15111202","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:55:15Z","timestamp":1762527315000},"page":"1202","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Outcomes in Non-Transected and Partially Transected Peripheral Nerve Injuries"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3445-5121","authenticated-orcid":false,"given":"Naveen Arunachalam","family":"Sakthiyendran","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Boston University School of Medicine, Boston, MA 02118, USA"},{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7282-1455","authenticated-orcid":false,"given":"Karter","family":"Morris","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3946-7247","authenticated-orcid":false,"given":"Caroline J.","family":"Cushman","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9587-2093","authenticated-orcid":false,"given":"Evan J.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"},{"name":"Department of Health Sciences, College of Health Sciences, Rush University, Chicago, IL 60612, USA"},{"name":"Hand and Microvascular Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anceslo","family":"Idicula","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"},{"name":"Hand and Microvascular Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7538-2857","authenticated-orcid":false,"given":"Brendan J.","family":"MacKay","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"},{"name":"Hand and Microvascular Surgery, University Medical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.hcl.2013.04.002","article-title":"Nerve physiology: Mechanisms of injury and recovery","volume":"29","author":"Menorca","year":"2013","journal-title":"Hand Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/mus.27787","article-title":"Optimal timing of needle electromyography to diagnose lesion severity in traumatic radial nerve injury","volume":"67","author":"Steenbeek","year":"2023","journal-title":"Muscle Nerve"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.jhsa.2021.08.020","article-title":"A Framework for Assigning Level of Evidence to Studies Using Institutional Databases","volume":"46","author":"Giladi","year":"2021","journal-title":"J. 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