Enhancing Median Nerve Regeneration: A Literature Review of Electrical Stimulation and Adjunctive Strategies

Peripheral nerve injuries continue to be a cause of long-term disability despite advances in surgical repair techniques.Complete recovery of nerve function is rarely seen, especially in mixed motor and sensory innervation.Injuries involving the median nerve are particularly debilitating due to their essential role in hand sensation, grip strength, and fine motor control.This review aims to examine the current standard of care for median nerve repair and examine the emerging role of electrical stimulation (ES) as an adjunctive therapy within a multimodal reconstructive framework.Current surgical management includes tension-free neurorrhaphy for amenable nerve gaps, interpositional nerve grafting for larger defects, and nerve conduits in selected short-gap injuries.The exact approach for each case is often dictated by the distance between damaged nerve endings.While current standards reliably restore anatomic continuity, they are limited by slow axonal regeneration, prolonged denervation, and Schwann cell senescence.Flaps can improve vascularized soft tissue coverage in the damaged area.Perfusion to the regenerating nerve increases axonal spread.ES in conjunction with standard treatment has been shown to enhance axonal outgrowth, accelerate target reinnervation, and promote pro-regenerative signaling in neurons and Schwann cells, particularly when applied early after repair and combined with structural reconstruction.