Is your interest in nerve injury focused on research? Because if you're thinking about clinical applications, as of today, not much can be done for nerve repair except perhaps end to end suturing or nerve grafts (if anyone knows otherwise, please correct me). So as far as technical training to do this, any of the three specialties you mentioned are probably equal. You might also think about ENT as they frequently work with nerves in the head/neck region. I would think that neuro would be most appropriate, especially if you're planning on doing basic science research in this area. But you're right, orthopedics does include work w/ peripheral nerves. I assume you're fairly early in your med school career. I would say you should choose your area of specialty based on whether you like the bread and butter cases you'll have to do during your residency, and whether you like working with the diseases and patients you would see. Because ultimately you would be able to shape you research and clinical career to your interests no matter which specialty you choose. As far as pros/cons, I think thats too difficult and too individual to answer - you have to do rotations in each and decide for yourself. Good luck.

The biggest name in peripheral nerve surgery is Lee Dellon at Union Memorial in Baltimore. He (and his partners) are mostly Hopkins trained plastic surgeons. I think they are hand trained too. Dellon has centers in Baltimore, Boston, Phoenix, and somewhere else and he does a ton of clinical work and research. Do a lit. search for him in the plastic and/or hand literature. If you're interested, I'd contact him about doing a rotation. He loves to teach and show everyone the cool stuff he's doing (cool to him at least.)

From what you describe in what you are interested in I think ortho or plastics would give you the best opportunities. Although there are some neurosurgeons who do carpal tunnels and brachial plexus cases this isn't overly common. When it comes to spine, neuro and ortho are probably 6 of one/half dozen of the other. In all honesty you will probably have to narrow your practice choices down a little as you finish your residency...if you do spine you won't be doing much peripheral nerve stuff and vice versa. I am an ortho resident currently doing research in nerve repair and regeneration. I think you would get good hand training in either ortho/plastics although I am biased to ortho. To decide between, I would look at the other things they do and pick which one you like better...ie boob jobs vs. frx fixation (not that simplistic but you get my drift). I would also look at research, there is actually a lot of cutting edge stuff going on with tissue engineering, nerve conduits, etc... If you want to look up the latest in peripheral nerve surgery go to the American Society for Reconstructive Microsurgery (www.microsurg.org) click on fellowships and do pubmed searches on the fellowship directors. Mackinnon from Wash U has published a lot. I feel like I have gotten a great experience in microsurgery and learning the physiology of nerve injury and regeneration during my research. If you have any other questions just PM me.