Article ID Journal Published Year Pages File Type
4069678 The Journal of Hand Surgery 2013 8 Pages PDF
Abstract

PurposeTo investigate digital nerve regeneration following implantation of collagen tubes in a prospective study.MethodsForty-five digital nerve defects (≤ 2.6 cm) in the hand were reconstructed in 35 patients (6 female, 29 male; mean age, 47 y). Nerve regeneration was evaluated at 3, 6, and 12 months after surgery by applying a sum score comprising static 2-point discrimination, sensory threshold with Semmes-Weinstein monofilament mechanical stimuli, warm/cold sensation, vibration sense, sharp/dull recognition, recognition of numbers, and subjective estimation of the patient. Electroneurography and ultrasound were also performed.ResultsIn the distribution of 60% of the operated nerves, very good or good recovery was found. In contrast to basic sensory function, the more complex static 2-point discrimination was more frequently impaired after 1 year. After 6 months, the sum score correlated with electroneurography. The type of injury altered the final sensory nerve function. Circular saw and iatrogenic injuries showed a negative correlation with final sensory nerve function. Complications (infection) were observed in 2 patients.ConclusionsOwing to the good functional outcome in the majority of cases, the use of collagen tubes is useful to span digital nerve defects up to 2.6 cm.Type of study/level of evidenceTherapeutic IV.

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