[Retrospective monocentric comparative evaluation by sifting of vein grafts versus nerve grafts in palmar digital nerves defects. Report of 32 cases].
OBJECTIVE
Palmar digital nerves defects can be treated by conventional nerve grafts or by means of a conduit, such as a vein. We compared a vein graft technique to a nerve graft technique in a retrospective monocentric study.


METHODS
A surgeon who was not involved in the treatment reviewed blind 15 nerve grafts and 17 vein grafts. The evaluation concerned sensitivity, pain, donor site morbidity, social integration and autoassessment of the benefits by the patient. Data were compacted by a sifting method eliminating bad results. The classical functional scores (British Medical Research Council, Möberg, Chanson, Alnot, Dumontier) were also used.


RESULTS
The evaluation was carried out at least 11 months after treatment. Defect was never greater than 30 mm. After sifting, vein grafts appeared less efficient than nerve grafts (41% good results against 73%), except in emergencies (86% good results).


CONCLUSIONS
For defect loss of no more than 30 mm in emergencies, the authors propose to use vein grafting. In other situations, the surgeon must take into account the patient's profile and the hemi-pulp concerned, dominant or non-dominant, before opting for a nerve or a vein graft.
Laveaux
C
C
Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, EA 4268 Innovation, Imagerie, Ingénierie et Intervention en Santé I4S, IFR 133, Inserm, France. christophe.laveaux@wanadoo.fr
Pauchot
J
J
Obert
L
L
Choserot
V
V
Tropet
Y
Y
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012677:Sensation; D013524:Surgical Flaps; D014459:Ulnar Nerve / Q000293:injuries* / Q000601:surgery*; D014680:Veins / Q000294:innervation* / Q000637:transplantation*; D055815:Young Adult