Mid-term results after isolated digital nerve repair in patients presenting with hand injury

Digital nerve lacerations are a common type of hand injury and one of the main causes of sensory impairment. The purpose of this study is to investigate the results of surgical treatment of traumatic digital nerve lesions in patient’s hands. We evaluated 65 patients with digital nerve injury that occurred after digital trauma between 2015 and 2018. The participants’ hypoesthesia scores on the numerical rating scale were greater than 5/10. Additionally, they felt hypoesthesia distally above the hand injury in their preliminary examinations at the emergency department. We analyzed the injuries of 65 patients (41 males, 24 females; mean age: 36 ± 2 years; age range: 19–56 years). Group 1 consisted of 26 patients who did not undergo surgery, whereas Group 2 consisted of 39 patients who underwent surgery. We conducted the Semmes– Weinstein monofilament test in Group 1. In total, 9 patients had normal sensations, 12 patients had light touch sensations; and 5 patients had protective sensations. We conducted nerve exploration surgery in Group 2. In total, the 12 patients who underwent this surgery were found to have no pathology in the digital nerve and identified to have neuropraxia. In the other 11 patients, the peripheral nerve was partially lacerated and it was repaired primarily, after performing the nerve exploration surgery on the remaining 16 patients. There wasn’t statistically significant difference between the patients who underwent surgery and who did not undergo surgery in terms of hypoesthesia resulting from nerve laceration.

Kaynakça

1. Cheng AS. Use of early tactile stimulation in rehabilitation of digital nerve injuries. Am J Occup Ther. 2000;54:159–65.

2. Fakin RM, Calcagni M, Klein HJ, et al. Long-term clinical outcome after epineuralcoaptation of digital nerves. J Hand SurgEur Vol. 2016;41:148–54.

3. Aberg M, Ljungberg C, Edin E, et al. Considerations in evaluating new treatment alternatives following peripheral nerve injuries: a prospective clinical study of methods used to investigate sensory, motor and functional recovery. J Plast Reconstr Aesthet Surg. 2007;60:103–13.

4. Kouyoumdjian JA. Peripheral nerve injuries: A retrospective survey of 456 cases. Muscle Nerve. 2006;34:785-8.

5. Lohmeyer JA, Siemers F, Machens HG, et al. The clinical use of artificial nerve conduits for digital nerve repair: a prospective cohort study and literature review. J Reconstr Microsurg. 2009;25:55-61.

6. Andjelković S, Lesić AR, Palibrk T, Vucković, et al. Digital nerve injury of the hand-epidemiologic and clinical analysis. Acta Chir Iugosl. 2010;57:95-8.

7. Keskin D, Seçkin Ü, Bodur H, ve ark. Tendon yaralanmalı hastalarımızın klinik özellikleri. Türk Fiz Tıp Rehab Derg. 2005;51:94-7.

8. Umay E, Demirel AÇ, Gürçay E, ve ark. El tendon taralanmalı hastalarda iyontoforez ve rehabilitasyon sonuçlarının değerlendirilmesi. Türk Fiz Tıp Rehab Derg. 2008;54:107-11.

9. Young L, Wray CR, Weeks PM. A randomized prospective comparison of fascicular and epineural digital nerve repairs. Plast Reconstr Surg. 1981;68:89.

10. Andelkovic SZ, Lesic AR, Bumbasirevic MZ, et al . The outcomes of 150 consecutive patients with digital nerve injuries treated in a single center. Turk Neurosurg. 2017;27:289-93.

11. Vipond N, Taylor W, Rider M. Postoperative splinting for isolated digital nerve injuries in the hand. J Hand Ther. 2007;20:222-30.

12. Yildiran G, Sutcu M, Akdag O, Tosun Z. Long-Term outcomes of digital nerve repair accompanied by digital artery injury in flexor zone 2. Surg J (N Y). 2019;6:7-9.

13. Konschake M, Burger F, Zwierzina M. Peripheral nerveanatomyrevisited: modern requirements for neuro imaging and micro surgery. Anat Rec (Hoboken). 2019;302:1325-32.

14. Bulut T, Akgün U, Çıtlak A, et al. Prognostic factors in sensory recovery after digital nerve repair. Acta Orthop Traumatol Turc. 2016;50:157-61.

15. Dunlop RLE, Wormald JCR, Jain A. Outcome of surgical repair of adult digital nerve injury: a systematic review. BMJ Open. 2019;9:025443.

16. Wormald JCR, Gardiner MD, Jain A. To repair or not rep

Kaynak Göster

Medicine Science
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012

14.6b8.5b