A new device for nerve approximation in traumatic injuries of extremities

Abstract

Precise approximation of two nerve endings is a major determinant of outcomes following nerve repairs. Despite technical and instrumental advances, approximation of nerve endings remains a challenge in reconstructive surgeries. We designed a new nerve approximator device for precise approximation of nerve endings and evaluated its utility in surgeries of peripheral nerves. We conducted a longitudinal study comparing postoperative functional outcomes between patients with peripheral nerve injury undergoing surgical repair by the new approximator device and conventional technique. A total of 204 nerve trunks were repaired by the new approximator device and 91 nerves by conventional technique. Patients were followed for a median of 30 months. Time required for nerve approximation was significantly reduced with the approximator device (4.5 min vs. 7 min, p < 0.0001). Nerve conduction velocity and tinel sign revealed similar results in both groups. However, grip, pinch and intrinsic muscle strength tests did not differ between the two groups. Our new nerve approximator device is feasible to use and reduces time of neurorrhaphy in microsurgical nerve repairs with sustained outcomes comparable to the conventional techniques. Level of Evidence: Level IV, therapeutic study.