Sensory Recovery 1 Year After Bridging Digital Nerve Defects With Collagen Tubes

Purpose To investigate digital nerve regeneration following implantation of collagen tubes in a prospective study. Methods Forty-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. Results In 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. Conclusions Owing 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. (J Hand Surg 2013;38A:90-97. Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved)