title: [Large diameter nerve conduits use in the upper limb: report of four cases and literature review].
abstract: Defects of the median, ulnar or radial nerves in the forearm, can be treated by conventional nerve grafts, or by interposing a synthetic guide such as nerve conduits. Wounds without nerve loss treated with simple suture may be supplemented by sleeving to prevent the nerve irritation symptoms using a nerve conduit or a vein sleeve. We studied the results of nerve conduits in both cases in a single-center retrospective study.
  
  
  METHODS
  Four patients underwent surgery with placement of a nerve conduit in the forearm, between May 2007 and January 2011. All patients were reviewed by the same examiner. Pain, tenderness, motor (Medical Research Council classification, MRC), time to return to work and self-evaluation by the patient were measured. The averages of these data were calculated and compared with results of other studies in the literature, the nerve grafts for defects and the Socket joints for venous ulcers.
  
  
  RESULTS
  The decrease is on average 30 months (2 years). The defect never exceeds 40mm and is 22mm on average. According to the classification MRC, sensitivity found after inserting nerve conduits in the forearm after a defect is excellent (S4) for two of three patients and good (S3) for the third. Motor results were very good (M4 and M3 for one patient) andM2 for the other. As for the insertion of a nerve conduit as a sleeve, the result is good in terms of sensitivity (S3) and excellent in terms of motor (M5) for our case in the study. For our small group of patients with neuroma we obtained, results similar to those published in the literature with conventional techniques.
  
  
  CONCLUSIONS
  The nerve conduits seem to give results similar to conventional techniques, in situations of defects or neuromasin the forearm, with a diameter greater than 2mm, but defects of less than 30mm.
authors: EA 4268 innovation, imagerie, ingénierie et intervention en santé « I4S » - IFR 133 Inserm, pôle innovation et technique chirurgicale, service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU Jean-Minjoz, université de Franche-Comté, boulevard Fleming, Besançon, France.
authors: E
authors: E
authors: Jardin
authors: S
authors: S
authors: Huard
authors: R
authors: R
authors: Chastel
authors: J
authors: J
authors: Uhring
authors: L
authors: L
authors: Obert
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000601:surgery*; D020423:Median Neuropathy / Q000601:surgery; D008875:Middle Aged; D009463:Neuroma / Q000601:surgery; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D010524:Peripheral Nervous System Neoplasms / Q000601:surgery; D019736:Prostheses and Implants; D012189:Retrospective Studies; D014459:Ulnar Nerve / Q000293:injuries / Q000601:surgery*; D020424:Ulnar Neuropathies / Q000601:surgery; D055815:Young Adult