title: Extrusion of a NeuroTube: A Case Report.
abstract: BACKGROUND
  Peripheral nerve injury is a common result of trauma. In cases of nerve gap, treatment may involve placement of a nerve conduit. This case involves a polyglycolic acid nerve conduit tube that was extruded through soft tissue. To our knowledge, this reactive process has only been previously documented in one article. This complication is not commonly known among hand surgeons, hence our interest in documenting it.
  
  
  METHODS
  We present the case of a 33-year-old male who injured his right nondominant thumb in a workplace saw accident. His complex wound involved the radial digital nerve, and the nerve was repaired using a polyglycolic acid nerve conduit. By postoperative week 4, part of the nerve conduit was extruding through the wound. No signs of infection were noted, and the remainder of his wounds had healed. The patient declined a nerve graft, so his wound was debrided with no further attempts at nerve repair. The wound healed uneventfully, and the patient returned to full duty without restrictions.
  
  
  CONCLUSIONS
  We believe this is the first documented case of extrusion of a nerve conduit through healthy soft tissue. Recent advancements in nerve allografts and conduits hold promise but are not yet in widespread use. We recommend the use of a collagen conduit to avoid extrusion of polyglycolic acid-based materials.
authors.affiliation: Department of Orthopedics, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Scott F M
authors.initials: SF
authors.lastname: Duncan
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kakinoki
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Marco
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Department of Orthopedics, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: William
authors.initials: W
authors.lastname: Kang
keywords: Extrude; hand injuries; peripheral nerve injuries; polyglycolic acid