title: Evaluation of sensory recovery after reconstruction of digital nerves of the hand using muscle-in-vein conduits in comparison to nerve suture or nerve autografting.
abstract: BACKGROUND
  Muscle-in-vein conduits are a good alternative solution to nerve autografts for bridging peripheral nerve defects since enough graft material is available and no loss of sensation at the harvesting area is expected. The purpose of this study was to compare regeneration results after digital nerve reconstruction with muscle-in-vein conduits, nerve autografts, or direct suture.
  
  
  METHODS
  46 patients with 53 digital nerve injuries of the hand subjected to direct suture (n = 22) or reconstruction of 1-6 cm long defects with either nerve autografts (n = 14) or muscle-in-vein conduits (n = 17) between 2008 and 2012, were examined using the two-point discrimination and Semmes-Weinstein Monofilaments.
  
  
  RESULTS
  The follow-up examinations took place 12 to 58 months after surgery. A median reduction of sensibility of 2 Semmes-Weinstein monofilaments compared with intact digits was observed after direct suture (DS) and of 2.5 and 2 Semmes-Weinstein monofilaments after reconstruction with autologous nerve grafts (ANG) and muscle-in-vein conduits (MVC), respectively. No statistically significant differences between all three groups could be found with a significance level set by a P < 0.006 (PDS-ANG = 0.24, PDS-MVC = 0.03, PANG-MVC = 0.52). After harvesting a nerve graft, reduction of sensibility at the donor site occurred in 10 of 14 cases but only in one case after harvesting a muscle-in-vein conduit.
  
  
  CONCLUSIONS
  Muscle-in-vein conduits may be a good alternative solution to autografts for the reconstruction of digital nerves, since no significant differences could be demonstrated between the two methods.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery with Burn Center, BG Trauma Center, University of Tuebingen, 72076, Tuebingen, Germany.
authors.forename: Theodora
authors.initials: T
authors.lastname: Manoli
authors.forename: Lukas
authors.initials: L
authors.lastname: Schulz
authors.forename: Stephane
authors.initials: S
authors.lastname: Stahl
authors.forename: Patrick
authors.initials: P
authors.lastname: Jaminet
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005385:Fingers / Q000294:innervation*; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D009416:Nerve Regeneration / Q000502:physiology*; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D010525:Peripheral Nerves / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012677:Sensation / Q000502:physiology*; D019738:Surgically-Created Structures; D013536:Suture Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation; D055815:Young Adult