title: Evaluation of sensibility after sensory reconstruction of the thumb.
abstract: We have studied the restoration of sensation in 24 patients after operations involving the digital nerves of the thumb. These comprised 10 neurorrhaphies, two nerve graftings, five replantations, one toe-to-thumb transfer and six neurovascular island flaps. The average follow-up period was 46 months. Greater sensitivity was found in the moving two-point discrimination (2PD) test than in the static 2PD test. The results of the Semmes-Weinstein test showed good correlation with the static 2PD test. Porter's letter test showed correlations with both 2PD tests, and the pulp-writing test showed good correlation with the moving 2PD test. The neurorrhaphy cases had the best results using the static 2PD and Semmes-Weinstein test, and had good restoration of sensation; the replantation cases were next best. After neurovascular island flaps, patients exhibited hypersensitivity, double sensation and distorted images on the pulp-writing test. Using this same test the nerve grafting cases had distorted touch perception and perceived a straight line as a curve. The pulp-writing test, using moving touch, is one method of examining mechanoreceptors and shows to what extent the patient perceives what touches the finger pulp; it gives a better indication of higher functions than the 2PD test.
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008465:Mechanoreceptors / Q000502:physiology; D008875:Middle Aged; D009619:Nociceptors / Q000502:physiology; D010525:Peripheral Nerves / Q000601:surgery* / Q000637:transplantation; D012092:Replantation; D012677:Sensation; D012684:Sensory Thresholds; D013933:Thumb / Q000293:injuries / Q000294:innervation*; D014034:Toes / Q000637:transplantation