[The treatment of digital nerve defects by the technique of vein conduit with nerve segment. A randomized prospective study].
OBJECTIVE
This study aims to compare the results of treating digital nerve defects with autologous sural nerve grafts as compared to using a vein conduit with interposition of a posterior interosseous nerve segment.


METHODS
This study is a clinical, prospective, randomized and blinded trial, comparing digital nerve defects treated by two different surgical techniques. It included a total of 50 digital nerves (25 patients in each treatment group), with a mean follow up of 10.2 (SD 1.4) months. In addition, the impact of five different factors (type of surgery, size of nerve defect, patient's age, type of lesion and lesion age) on the final outcome were evaluated.


RESULTS
In respect of the sensory assessment, the static two point discrimination score was 6 mm for both groups . According to the Al-Ghazal Scoring Method, the autolougus sural nerve graft group scored a mean (sd) of 7.7 (1.9) points, while vein conduit with interposition of a posterior interosseous nerve segment group scored 6.9 (2.1). Under multivariate analysis, both patient's age and lesion age proved to be important independent factors, having influenced almost all results. The group treated with vein conduit with interposition of a posterior interosseous nerve segments showed fewer complications than the group treated using sural nerve.


CONCLUSIONS
Based on the results obtained, we concluded that the sensory scores were equal in both groups. We also concluded that the vein conduit and posterior interosseous nerve graft procedure offered some advantages in terms of the complication rate.
Calcagnotto
G-N
GN
Service de chirurgie de la main, hôpital da PUC, Porto Alegre Brésil, avenue Ipiranga 6690, conj 216, Centro Clinico PUC-RS, Porto Alegre-RS, CEP 90610-000, Brésil. gustacal@hotmail.com
Braga Silva
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000294:innervation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D020127:Recovery of Function; D013497:Sural Nerve / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation*