The Clinical Use of Artificial Nerve Conduits for Digital Nerve Repair: A Prospective Cohort Study and Literature Review

被引:114
作者
Lohmeyer, Joern A. [1 ,2 ]
Siemers, Frank [2 ]
Machens, Hans-Guenther [2 ]
Mailaender, Peter [2 ]
机构
[1] Tech Univ Munich, Klinikum Rechts Isar, Klin & Poliklin Plast Chirurg & Handchirurg, D-81675 Munich, Germany
[2] Univ Hosp Schleswig Holstein, Burn Unit, Lubeck, Germany
关键词
Digital nerve; nerve tube; nerve reconstruction; collagen; clinical study; POLYGLYCOLIC ACID CONDUITS; ULNAR NERVES; RECONSTRUCTION; INJURIES; DEFECTS; FOREARM; GRAFT; TUBE;
D O I
10.1055/s-0028-1103505
中图分类号
R61 [外科手术学];
学科分类号
摘要
Tubulization as an alternative to autologous nerve grafting successfully bridges relatively short nerve gaps. Digital nerve lesions are ideal for clinical Outcome studies, but only a few data have been published so far. We are presenting our clinical experiences based on a review of the outcome and techniques in the current literature. Fifteen digital nerve lesions in 1.4 patients have been overcome by interpositional grafting of a hollow collagen I conduit. A follow-up of 12 months could be guaranteed in 12 cases. The mean nerve gap was 1.2.5 +/- 3.7 mm. Four out of 12 patients, assessed 12 months postoperatively, showed excellent sensibility (S4). Five patients achieved good sensibility, one poor, and two no sensibility. Our results confirm tubulization as one possible technique in nerve rcconstruction. However, the indication has to be set carefully, and the operation still requires solid microsurgical skills, especially for proper handling and debridement of the severed nerve endings.
引用
收藏
页码:55 / 61
页数:7
相关论文
共 28 条
  • [11] Salvage of sensation in a hallux-to-thumb transfer by nerve tube reconstruction
    Dellon, A. Lee
    Maloney, Christopher T., Jr.
    [J]. JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 2006, 31A (09): : 1495 - 1498
  • [12] Dellon AL, 2001, PLAST RECONSTR SURG, V107, P1924, DOI 10.1097/00006534-200106000-00066
  • [13] PERCENTAGE OF NERVE INJURIES IN WHICH PRIMARY REPAIR CAN BE ACHIEVED BY END-TO-END APPROXIMATION - REVIEW OF 2,181 NERVE LESIONS
    DEMEDINACELI, L
    PRAYON, M
    MERLE, M
    [J]. MICROSURGERY, 1993, 14 (04) : 244 - 246
  • [14] Median, ulnar, and combined median-ulnar nerve injuries: Functional outcome and return to productivity
    Jaquet, JB
    Luijsterburg, AJM
    Kalmijn, S
    Kuypers, PDL
    Hofman, A
    Hovius, SER
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2001, 51 (04): : 687 - 692
  • [15] Lohmeyer J, 2007, CHIRURG, V78, P142, DOI 10.1007/s00104-006-1269-1
  • [16] Bridging extended nerve defects with an artificial nerve graft containing Schwann cells pre-seeded on polyglactin filaments
    Lohmeyer, J. A.
    Shen, Z. -L.
    Walter, G. F.
    Berger, A.
    [J]. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, 2007, 30 (01) : 64 - 74
  • [17] Lundborg G, 2004, J HAND SURG-BRIT EUR, V29B, P100, DOI 10.1016/j.jhsb.2003.09.018
  • [18] MACKINNON S, 1988, SURG PERIPHERAL NERV, P637
  • [19] CLINICAL NERVE RECONSTRUCTION WITH A BIOABSORBABLE POLYGLYCOLIC ACID TUBE
    MACKINNON, SE
    DELLON, AL
    [J]. PLASTIC AND RECONSTRUCTIVE SURGERY, 1990, 85 (03) : 419 - 424
  • [20] The epidemiology and management of upper limb peripheral nerve injuries in modern practice
    McAllister, RMR
    Gilbert, SEA
    Calder, JS
    Smith, PJ
    [J]. JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME, 1996, 21B (01) : 4 - 13