Abstract
Objective:The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute or delayed repair of segmented digital nerve injuries.Patients and Methods:13 digital nerve defects of 11 patients; treated with interposition of LACN graft that harvested from ipsilateral extremity were included in the study. Mean follow up period was 35, 7 months. The mean time from injury to grafting is 53, 3 days. The results of the mean 2PDT and SWMT values of injured /uninjured finger at the end of follow up period were evaluated with Paired T test. The correlation between the defect length and the difference of 2PDT, SWMT values between the uninjured and injured finger at the end of follow up period; were evaluated with Pearson - correlation analysis.Results:The mean value of our 2PDT and SWMT results are ~5,923, ~3, 52, respectively in which can be interpreted between the normal and diminished light touch. The defect length and difference percentage of SWMT values is positively and significantly correlated statistically. Mean length of interposed nerve grafts was 18.5 mm. The age of the patient and the mean values of 2PDT and SWMT with the difference % of 2PDT and % of SWMT are not statistically correlated.Conclusion:Based on results regarding sensory regaining at recipient side and negligible sensory deficit at harvesting side, we suggest that lateral antebrachial cutaneous nerve might be a valuable graft option for digital nerve defects.
Highlights
Injury to digital nerves of the hand is common and they are the most frequent cause of sensory impairment of the1874-3250/17 2017 Bentham OpenThe Open Orthopaedics Journal, 2017, Volume 11 hand [1]
The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute, segmented or delayed repair of digital nerve injuries in a clinical trial
According to our study, using of lateral antebrachial cutaneous nerve (LACN) as a donor source for mean 18,5 mm digital nerve defect, improved 2PDT and SWMT measurements after the surgery on mean follow up time 35, 7 months
Summary
Injury to digital nerves of the hand is common and they are the most frequent cause of sensory impairment of the1874-3250/17 2017 Bentham OpenThe Open Orthopaedics Journal, 2017, Volume 11 hand [1]. A nerve gap is defined as “the distance between two ends of a divided nerve”. It is caused by the nerve tissue lost due to trauma or debridement, and by actual retraction of nerve stumps [2]. Peripheral nerve injuries with gaps larger than 1-2 cm require bridging strategies for nerve repair/coaptation. Achievement of satisfactory functional recovery following the repair of a segmental peripheral nerve defect always posed a challenge for the surgeons. It has long been established that the repair of a segmental defect of nerve usually gives very poor results when the nerve coaptation of stumps is done under tension [4 - 7]
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