The clinical use of artificial nerve conduits for digital nerve repair: a prospective cohort study and literature review.
Tubulization as an alternative to autologous nerve grafting successfully bridges relatively short nerve gaps. Digital nerve lesions are ideal for clinical outcome studies, but only a few data have been published so far. We are presenting our clinical experiences based on a review of the outcome and techniques in the current literature. Fifteen digital nerve lesions in 14 patients have been overcome by interpositional grafting of a hollow collagen I conduit. A follow-up of 12 months could be guaranteed in 12 cases. The mean nerve gap was 12.5 +/- 3.7 mm. Four out of 12 patients, assessed 12 months postoperatively, showed excellent sensibility (S4). Five patients achieved good sensibility, one poor, and two no sensibility. Our results confirm tubulization as one possible technique in nerve reconstruction. However, the indication has to be set carefully, and the operation still requires solid microsurgical skills, especially for proper handling and debridement of the severed nerve endings.
Lohmeyer
Jörn A
JA
Plastic Surgery, Hand Surgery, Burn Unit, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany. lohmeyer@lrz.tum.de
Siemers
Frank
F
Machens
Hans-Günther
HG
Mailänder
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002648:Child; D024042:Collagen Type I; D003646:Debridement; D005260:Female; D005385:Fingers / Q000294:innervation* / Q000601:surgery*; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology*; D011446:Prospective Studies; D016896:Treatment Outcome
D001672:Biocompatible Materials; D024042:Collagen Type I