title: Allograft reconstruction for digital nerve loss.
abstract: OBJECTIVE
  To investigate the outcomes of digital nerve repairs using processed nerve allograft for defects measuring 30 mm or less.
  
  
  METHODS
  Seventeen patients with 21 digital nerve lacerations in the hand underwent reconstruction with processed nerve allograft. Outcome data for 14 patients with 18 digital nerve lacerations were available for analysis. Postoperative outcome data were recorded at a minimum of 12 months and an average of 15 months. The average nerve gap measured 11 mm (range, 5-30 mm). Outcome measures included postoperative sensory examination as assessed by Semmes-Weinstein monofilaments and static and moving 2-point discrimination. Pain was graded using a visual analog scale throughout the recovery period. In addition, patients completed the Quick Disabilities of the Arm, Shoulder, and Hand survey before and after surgery.
  
  
  RESULTS
  Using Taras outcome criteria, 7 of 18 (39%) digits had excellent results, 8 of 18 (44%) had good results, 3 of 18 (17%) digits had fair results, and none had poor results. At final follow-up, Semmes-Weinstein monofilament testing results ranged from 0.08 g to 279 g. Quick Disabilities of the Arm, Shoulder, and Hand scores recorded at the patient's first postoperative visit averaged 45 (range, 2-80), and final scores averaged 26 (range, 2-43). There were no signs of infection, extrusion, or graft reaction.
  
  
  CONCLUSIONS
  The data suggest that processed nerve allograft provides a safe and effective alternative for the reconstruction of peripheral digital nerve deficits measuring up to 30 mm.
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania; Division of Hand Surgery, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, Pennsylvania; Philadelphia Hand Center, Philadelphia, Pennsylvania. Electronic address: jstaras@handcenters.com.
authors.forename: John S
authors.initials: JS
authors.lastname: Taras
authors.forename: Nirav
authors.initials: N
authors.lastname: Amin
authors.forename: Nimit
authors.initials: N
authors.lastname: Patel
authors.forename: Lucy A
authors.initials: LA
authors.lastname: McCabe
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D004185:Disability Evaluation; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000294:innervation*; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome
keywords: Allograft; digital nerve; nerve conduit; nerve reconstruction; peripheral nerve