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J Reconstr Microsurg 2014; 30(04): 227-234
DOI: 10.1055/s-0033-1358788
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Joern Andreas Lohmeyer
1   Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
2   Department of Plastic Surgery, Agaplesion Diakonieklinikum Hamburg, Klinik für Plastische Chirurgie, Hamburg, Germany
,
Yasmin Kern
1   Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
,
Daniel Schmauss
1   Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
,
Felix Paprottka
1   Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
,
Felix Stang
3   Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
,
Frank Siemers
3   Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
,
Peter Mailaender
3   Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
,
Hans-Guenther Machens
1   Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
› Author Affiliations
Further Information

Publication History

26 July 2013

07 September 2013

Publication Date:
12 December 2013 (online)

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Abstract

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 26 mm were reconstructed with nerve conduits made from bovine collagen I. Sensibility was assessed 1 week, 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 ± 2.3 mm (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 > 15 mm, 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.

Keywords

digital nerve reconstruction - nerve conduit - collagen I conduit - nerve injury - hand
 

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