Recovery of mechanical detection thresholds after direct digital nerve repair versus conduit implantation

J Hand Surg Eur Vol. 2017 Sep;42(7):720-730. doi: 10.1177/1753193417699777. Epub 2017 Apr 10.

Abstract

The purpose of this study was to assess sensory and functional nerve recovery after digital nerve injury in patients with an end-to-end suture (S) or with implantation of a collagen conduit (C) to bridge a nerve gap. Fifteen S and 11 C with a follow-up of 6-36 months and 28 healthy control participants were enrolled. Methods of assessments were quantitative sensory testing, the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), range of motion and the painDetect questionnaire. After both procedures, sensory profiles showed largely recovered function of C and Aδ fibres but severe loss of Aβ-fibre function leading to increased mechanical detection thresholds. There was only minimal allodynia. Severe pain was absent. Patients with conduits reported more functional impairment, especially in work performance, which correlated with the assessed loss of Aß-fibre function.

Level of evidence: III.

Keywords: Nerve conduit; digital nerve injury; nerve recovery; quantitative sensory testing; somatosensory profiles.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Collagen
  • Disability Evaluation
  • Female
  • Finger Injuries / physiopathology
  • Finger Injuries / surgery*
  • Fingers / innervation*
  • Fingers / surgery
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Outcome Assessment, Health Care
  • Pain Measurement
  • Peripheral Nerve Injuries / physiopathology
  • Peripheral Nerve Injuries / surgery*
  • Prostheses and Implants
  • Quality of Life
  • Recovery of Function* / physiology
  • Surveys and Questionnaires
  • Suture Techniques
  • Touch Perception / physiology

Substances

  • Collagen