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We've been told that our son's arm can be saved after a terrible car accident but some of the major nerves have been crushed. The prognosis is "guarded." What can you tell us what is possible -- can the nerves plump themselves back up and start firing again?

Major peripheral nerve injuries are a challenge. With a growth rate of only one to three millimeters per day, it can take months for the nerve to heal as much as it will. And with the nerve's limited ability to heal, full function doesn't always return. That may be why your son has been given a "guarded" prognosis -- there's just no way to know for sure the final outcome. Recovery depends in part on the type of injury, severity, and location. Many other factors figure in as well. For example, nutrition is a key factor. But even more important are the changes the tissues supplied by the damaged nerve are experiencing because of the loss of nerve impulses. Fat and fibrous scar tissue can get in the way of the regenerating nerve bridging the gap from one side to the other. And without the nerve signals, the muscles start to waste (atrophy) and get weaker and weaker. All that sounds like bad news. But there is good news -- scientists are indeed busily researching and investigating many different ways to approach this problem from all sides. It's only a matter of time before we have the information needed to guide faster and more effective nerve regeneration.

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