Peripheral Nerve & Brachial Plexus | Core Clinical Protocols & FAQs

Peripheral nerve repair is a microsurgical procedure that realigns and sutures severed nerves under high magnification to restore sensation and muscle movement. When a nerve gap is present, an autologous nerve graft (such as the sural nerve) is used to bridge the gap without tension. Dr. Vishal Purohit performs advanced microsurgical nerve repairs at Jaipur Hospital in Jaipur.

Clean, sharp nerve lacerations should ideally be repaired primarily within 24 to 72 hours of injury to optimize axonal alignment before nerve ends retract. However, delayed nerve repair or cable grafting can still be successfully performed up to several months post-injury. In Jaipur, Dr. Vishal Purohit provides emergency and delayed nerve evaluations.

Following surgical repair, regenerating nerve axons advance down the distal nerve pathway at a predictable rate of approximately 1 millimeter per day, or about 1 inch per month. Recovery of sensation and muscle control depends directly on the distance from the repair site to the target muscle or fingertip. Dr. Vishal Purohit monitors regeneration progress at Jaipur Hospital.

The sural nerve is an expendable sensory nerve running down the back of the lower calf, harvested to bridge major nerve gaps in the arm or hand. Taking this graft leaves only a small, harmless patch of numbness along the outer edge of the foot that diminishes over time, with zero effect on walking or running. In Jaipur, Dr. Vishal Purohit uses minimally invasive graft harvesting.

Suturing a nerve under tension restricts internal endoneurial microvascular blood flow, creating dense scar tissue (fibroma) that completely blocks regenerating axonal growth cones. When a gap prevents tension-free apposition, nerve cable grafting is mandatory to achieve successful reinnervation. Dr. Vishal Purohit prioritizes tension-free repairs at Jaipur Hospital.

Peripheral nerve surgery in Jaipur ranges from ₹30,000 for simple digital nerve repair to ₹65,000–₹1,20,000 for complex multi-cable sural nerve grafting of major forearm trunks. Pricing includes operating microscope use, microsurgical instruments, anesthesia, and hospital care. Dr. Vishal Purohit provides transparent, itemized estimates at Jaipur Hospital.

A traumatic neuroma is a disorganized, hypersensitive tangle of regenerating nerve sprouts that forms when a cut nerve cannot find its distal pathway, causing excruciating electric shock-like pain. Microsurgical coaptation or proper nerve capping prevents neuroma formation. In Jaipur, Dr. Vishal Purohit treats and prevents painful neuromas.

The limb is protected in a molded splint for 3 weeks to prevent accidental stretching or disruptive traction across the delicate microsurgical suture line. Controlled active physiotherapy begins gently in week 4 to prevent joint stiffness without straining the nerve. Dr. Vishal Purohit guides structured hand rehabilitation in Jaipur.

Sensory re-education is a guided neuro-rehabilitation program that retrains the brain to interpret sensory signals returning to the hand from regenerating nerves through textured tactile exercises. This dramatically improves fine discrimination, such as recognizing coins and keys without looking. In Jaipur, Dr. Vishal Purohit incorporates sensory retraining protocols.

Dr. Vishal Purohit holds an M.Ch. in Plastic Surgery and has extensive microvascular and peripheral nerve fellowship training, utilizing high-power surgical microscopes and 10-0 microsutures for precise fascicular alignment. His evidence-based techniques maximize sensory and motor recovery. Consultations are available at Jaipur Hospital, Tonk Road, Jaipur.