[Results of the reconstruction of small sensory nerves defects with autologous vein conduits].
Sural nerve grafting for the reconstruction of small defects of sensory nerves is associated with relatively considerable donor site sacrifice which is loss of sensation on the lateral side of the foot. One of the alternative and accepted methods of reconstruction of nerve gaps is bridging with autologous vein conduit. Material and methods. Thirty-two patients with post-traumatic sensory nerve gaps within the hand and forearm were operated on by vein grafting. Twenty-ones were operated as elective and 11 in emergency. Nerve defect was 1-2 cm long in all patients. In seven patients a painful neuroma within the damaged nerve was present. The results were assessed mean of 8 months after surgery. Two-point discrimination test and light touch threshold test were performed. Results. Twenty-five patients were available for final examination. None of them recovered normal threshold of the light touch (press with 0.07 g filament). Eleven patients (44%) could feel touch with 0.2 g filament, seven patients (28%) with 2 g filament and seven with 4 g filament. Six patients (24%) restored two-point discrimination 6 mm, twelve (48%) achieved 10 mm, four (16%) achieved 15 mm, and three had worse than 15 mm. Regarding satisfactory recovery of the sensation at the level of 10 mm two-point discrimination and 2g threshold of the light touch, these results were noted in 18 patients (72%). Presented outcomes as well as review of the literature allows us to conclude that vein grafting of the sensory nerve defects of 2 cm or less is a reasonable solution which is worth to apply in any clinical situation.
Zyluk
Andrzej
A
Klinika Chirurgii Ogólnej i Chirurgii Reki, Pomorska Akademia Medyczna w Szczecinie.
Puchalski
Piotr
P
Walaszek
Ireneusz
I
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010525:Peripheral Nerves / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014110:Touch; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation*