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Introduction: Traumatic peripheral nerve injuries are common and can lead to significant morbidity for the patient. Management of these injuries is often challenging for the physician. We encountered two such patients with extensive upper extremity injuries with little or no nerve function.

Methods: A review of the history and outcomes was conducted. Both patients had extensive injuries and underwent neurolysis and reconstruction of the soft tissue envelope around the nerve.

Results: Both patients saw improvement beyond our expectations. From starting out as preparatory surgery for more extensive reconstruction, both have showed enough functional return that there may be no further surgery required.

Conclusion: Neurolysis and soft tissue reconstruction may be a viable option to improving functional outcome after traumatic damage to upper extremity neurological function. It is unclear whether the reconstruction of soft tissue envelope, neurolysis or a combination of both was the main factor and further studies are needed to clearly identify the cause. But the encouraging results we observed indicate the potential benefits of neurolysis and tissue reconstruction even in patients who are poor candidates for these procedures and this may be an option before more extensive surgeries are undertaken.