Prospective Clinical Study on Digital Nerve Repair with Collagen Nerve Conduits and Review of Literature

被引:45
作者
Lohmeyer, Joern Andreas [1 ,2 ]
Kern, Yasmin [1 ]
Schmauss, Daniel [1 ]
Paprottka, Felix [1 ]
Stang, Felix [3 ]
Siemers, Frank [3 ]
Mailaender, Peter [3 ]
Machens, Hans-Guenther [1 ]
机构
[1] Tech Univ Munich, Klinikum Rechts Isar, Dept Plast Surg & Hand Surg, D-80290 Munich, Germany
[2] Klin Plast Chirurg, Dept Plast Surg, Hamburg, Germany
[3] Univ Hosp Schleswig Holstein, Burn Unit, Kiel, Germany
关键词
digital nerve reconstruction; nerve conduit; collagen I conduit; nerve injury; hand; POLYGLYCOLIC ACID; RECONSTRUCTION; INJURIES; DEFECTS; EXPERIENCE; TUBULIZATION; FOREARM; RETURN; ULNAR;
D O I
10.1055/s-0033-1358788
中图分类号
R61 [外科手术学];
学科分类号
摘要
Little data are available concerning conduit repair of digital nerve lesions. We are presenting a prospective two-center cohort study on digital nerve reconstruction with collagen nerve conduits. The data are put into the context of a comprehensive review of existing literature. Over a period of 3 years, all consecutive digital nerve lesions that could not be repaired by tensionless coaptation with a gap length of less than 26mm were reconstructed with nerve conduits made from bovine collagen I. Sensibility was assessed 1week, 3, 6, and 12 months postoperatively by static and moving 2-point-discrimination (2PD) and monofilament testing. Forty-nine digital nerve lesions in 40 patients met the inclusion criteria. The mean nerve gap was 12.3 +/- 2.3mm (span 5-25 mm). Forty nerve reconstructions could be included in the 12-month follow-up. Three cases, assessed 12 months postoperatively, showed excellent sensibility (static 2PD<6 mm). Seventeen achieved good (2PD 6-10 mm), 5 fair (2PD 11-15 mm), 6 poor (2PD>15mm, but protective sensibility), and 9 achieved no sensibility. Monofilament test results were significantly better if gap length was shorter than 12 mm. Our results confirm tubulization as one possible technique in nerve reconstruction for gap lengths of 5 to 25 mm.
引用
收藏
页码:227 / 233
页数:7
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