Sensible Nervenfunktion nach unilateraler digitaler Gefäß-Nerven-Verletzung: Nervennaht mit und ohne Arterienanastomose

Abstract

This study compares the clinical results of microsurgical nerve repairs in unilateral digital arterial-nerve-injuries with and without repair of the finger artery. Between January 2000 and May 2007 a total of 81 patients with unilateral digital vascular nerve bundle lesions, including concomitant soft-tissue tendon lesions, were operated on the emergency day. Forty of the 56 patients treated with a nerve repair alone took part in a follow-up after an average of 47 (7-87) months. Twenty of the 25 patients treated with a microsurgical arterial and nerve repair took part in a follow-up after an average of 12 (6-66) months; 3 patients were excluded due to a negative digital Allen-test. In addition to anamnestic data, peripheral nerve function was evaluated by the static and the moving two-point discrimination test, and by Semmes-Weinstein pressure aesthesiometer in the autonomous zone of the affected side of the injured finger. Stereognosis also was examined. The patency of the reconstructed digital artery was tested by a digital Allen-test. No statistically significantly worse results were found in patients with a nerve repair alone compared to patients with additional repair of the finger artery. Repair of the finger artery therefore appears to offer no improvement of the clinical outcome following nerve repair in unilateral injury of a digital arterial-nerve bundle.