title: Prospective clinical study on digital nerve repair with collagen nerve conduits and review of literature.
abstract: Little data are available concerning conduit repair of digital nerve lesions. We are presenting a prospective two-center cohort study on digital nerve reconstruction with collagen nerve conduits. The data are put into the context of a comprehensive review of existing literature. Over a period of 3 years, all consecutive digital nerve lesions that could not be repaired by tensionless coaptation with a gap length of less than 26 mm were reconstructed with nerve conduits made from bovine collagen I. Sensibility was assessed 1 week, 3, 6, and 12 months postoperatively by static and moving 2-point-discrimination (2PD) and monofilament testing. Forty-nine digital nerve lesions in 40 patients met the inclusion criteria. The mean nerve gap was 12.3 ± 2.3 mm (span 5-25 mm). Forty nerve reconstructions could be included in the 12-month follow-up. Three cases, assessed 12 months postoperatively, showed excellent sensibility (static 2PD <6 mm). Seventeen achieved good (2PD 6-10 mm), 5 fair (2PD 11-15 mm), 6 poor (2PD >15 mm, but protective sensibility), and 9 achieved no sensibility. Monofilament test results were significantly better if gap length was shorter than 12 mm. Our results confirm tubulization as one possible technique in nerve reconstruction for gap lengths of 5 to 25 mm.
authors: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Joern Andreas
authors: JA
authors: Lohmeyer
authors: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Yasmin
authors: Y
authors: Kern
authors: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Daniel
authors: D
authors: Schmauss
authors: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Felix
authors: F
authors: Paprottka
authors: Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
authors: Felix
authors: F
authors: Stang
authors: Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
authors: Frank
authors: F
authors: Siemers
authors: Plastic, Hand and Reconstructive Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
authors: Peter
authors: P
authors: Mailaender
authors: Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Hans-Guenther
authors: HG
authors: Machens
mesh_terms: D001672:Biocompatible Materials; D015331:Cohort Studies; D024042:Collagen Type I; D003646:Debridement; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000294:innervation / Q000601:surgery*; D048091:Guided Tissue Regeneration / Q000379:methods; D006801:Humans; D009416:Nerve Regeneration; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D024042:Collagen Type I