A modified digital nerve repair technique in replantation of rotational avulsed fingers

Abstract

Objective To modify the conventional technique for repairing digital nerve in replantation of avulsed fingers, and to evaluate its clinical outcomes. Methods From August 2011 to June 2015, 12 cases of avulsed fingers were replanted. The avulsed digital nerve on one side was harvested as a graft for repair of the digital nerve on the other side. The distal donor digital nerve was then sutured to digital nerve of the recipient side in an end-to-side fashion. Results All 12 replanted fingers survived uneventfully with primary wound healing.All the patients were follow-up for 12 to 18 months. Perfusion, appearance and function of the replanted fingers were good. Pain sensation and temperature sensation returned. Two-point discrimination was 4 to 9 mm on the graft repair side of finger pulp, equivalent to S3+ to S4. Sensory recovery on the end-to-side neurorrhaphy side was S3 to S3+. According to the criteria for functional assessment of replanted fingers issued by the Hand Surgery Society of Chinese Medicine Association, the results were excellent in 7 cases and good in 5 cases. Conclusion In replantation of avulsed fingers, sensory restoration of the pulp can be achieved by using a segment of the digital nerve from one side to graft repair digital nerve of the other side while suturing the distal donor digital nerve to the graft repair digital nerve in an end-to-side fashion. Key words: Fringer injuries; Replantation; Nerve grafting