Effect of sensory re-education after low median nerve complete transection and repair.
OBJECTIVE
To compare the sensory results of patients with low median nerve complete transection and repair, with and without sensory re-education.


METHODS
We studied 40 patients, aged 20 to 32 years, with low median nerve complete transection. Primary epineural repair using 8-0 single-strand sutures was done in all patients. Hands were immobilized in a splint for 4 weeks, followed by physical therapy for 1 month. At a mean of 3.5 months (range, 3-4 months) after surgery, when vibration sense (pallesthesia), using the 256-cycles-per-second tuning fork, was perceived at the fingertips of the 3.5 radial fingers innervated by the median nerve, the patients were randomly assigned to 2 equal groups: group A patients were rehabilitated with a sensory re-education program, and group B patients had no further treatment. Clinical evaluation at 18 months after surgery (range, 17.5-18.5 months) included locognosia (the ability to localize touch), the static and moving 2-point discrimination tests, and the Moberg pick-up test.


RESULTS
All patients were included in the postoperative evaluation. Static and moving 2-point discrimination were not statistically significant between groups. Locognosia was significantly improved in group A, and a statistical trend was identified regarding the Moberg pick-up test in group A compared to group B.


CONCLUSIONS
Sensory re-education appeared to have significant value only in re-education of locognosia at 18 months after low median nerve complete transection and repair.


METHODS
Therapeutic II.
Mavrogenis
Andreas F
AF
First Department of Orthopaedics, Athens University Medical School, 15562 Holargos thens, Greece. andreasfmavrogenis@yahoo.gr
Spyridonos
Sarantis G
SG
Antonopoulos
Dimitris
D
Soucacos
Panayotis N
PN
Papagelopoulos
Panayiotis J
PJ
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000503:physiopathology*; D020423:Median Neuropathy / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery; D009048:Motor Skills / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D012677:Sensation / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult