Digital nerve injuries: a review of predictors of sensory recovery after microsurgical digital nerve repair.

Autor: Mermans JF, Franssen BB, Serroyen J, Van der Hulst RR
Jazyk: angličtina
Zdroj: Hand (New York, N.Y.) [Hand (N Y)] 2012 Sep; Vol. 7 (3), pp. 233-41. Date of Electronic Publication: 2012 Jun 28.
DOI: 10.1007/s11552-012-9433-1
Abstrakt: Background: Optimal surgical management of digital nerve lesions remains uncertain despite the publication of numerous studies. The purposes of this review were primarily to analyze whether there is a superior surgical technique for digital nerve repair and secondarily to statistically verify the variables to be predictors of sensory recovery.
Methods: A literature search was performed using PubMed including citation from MEDLINE. Studies were included if they involved patients with digital nerve lacerations in whom end-to-end neurorrhaphy, nerve grafts, conduits, or end-to-side neurorrhaphy were performed. Further, the sensory outcome had to be assessed according to the modified American Society for Surgery of the Hand guidelines to stratify for two-point discrimination in millimeters. The variables age, follow-up, delay in repair, type of trauma, and gap length were extracted. The association between each predictor and response was assessed using a linear mixed model and corrected for heterogeneity between studies. Significance was considered present at p ≤ 0.05.
Results: Of the 34 articles found, 14 articles were included giving appropriate individual data for 191 nerves. There was no statistically significant difference in outcome between operation techniques. Age and follow-up were verified predictors of sensory recovery.
Conclusion: In this review, the type of operation for digital nerve repair does not influence sensory outcome. However, we verified outcome to be influenced by the patient's age and the follow-up period. To add more scientific evidence to our results, larger cohort prospective studies need to be done with better detailed description of data.
Databáze: MEDLINE
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