[Influence of palmar digital artery patency on neurological recovery of palmar digital nerve lesions].
Should the palmar digital artery be repaired in the pedicular section of the finger? This repair is discussed in the case of a unilateral pedicular lesion on a vascularised finger, and often neglected in current surgical practice. The problem is knowing the role of a permeable artery in sensory recovery and cold intolerance. The author presents a retrospective study on palmar digital nerve reinnervation after section with or without palmar digital artery section. Artery permeability was studied by doppler ultrasonography. Forty nerves in 35 patients were studied after at least 3 years had passed. Twenty-five nerves were associated with a permeable artery, 15 with a non permeable artery. The functional result was evaluated with the Weber test (S2PD) and by the presence or absence of cold intolerance. This work demonstrates the statistically significant role of the palmar digital artery in sensitive recovery quality and cold intolerance appearance. Its permeability ensures a better sensitive result with an 8.84 mm S2PD versus 13.47 mm with a non permeable artery. The benefit of the systematic repair of palmar digital artery is thus demonstrated for the first time. This repair is all the more justified if local conditions are unfavorable, in particular in contuse wounds with associated lesions (tendinous or bone).
Piquet
M
M
Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, pôle innovation et technique chirurgicale, CHU Jean Minjoz, université de Franche-Comté, Besançon, France.
Obert
L
L
Laveaux
C
C
Sarlieve
P
P
Vidal
C
C
Tropet
Y
Y
Pauchot
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D016009:Chi-Square Distribution; D006225:Hand / Q000098:blood supply / Q000294:innervation; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009416:Nerve Regeneration; D018579:Patient Selection; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D020886:Somatosensory Disorders / Q000209:etiology; D013536:Suture Techniques; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency