The clinical effect of the application of small diameter artificial nerve conduit on preventing neuropathic pain after crush injury of the digital nerve

Abstract

Objective To observe the clinical effect of the application of small diameter artificial nerve conduit on preventing and reducing the occurrence of neuropathic pain after crush injury of the digital nerve. Methods From January 2015 to June 2016, 37 patients (50 digits) diagnosed with crush injury of the digital nerve were randomly divided into artificial nerve group and control group. There were 19 patients (25 digits) in the experimental group and 18 patients (25 digits) in the control group. Both groups underwent surgical debridement and digital nerve repair by the same surgeon, and were followed up and evaluated at 2 weeks, 6 weeks, 3 months and 6 months after the surgery. Every patient was assessed with visual analogue scale (VAS) for the degree of neuropathic pain. Results In the artificial nerve experimental group, there were 2 patients (2 digits) with neuropathic pain symptoms at the peak 2 weeks after the operation which significantly relieved at 6 weeks. In the control group, there were 5 patients (8 digits) of neuropathic pain symptoms at the peak from 2 to 6 weeks which significantly relieved within 3 months after the operation. Statistics analysis indicated that patients in the artificial nerve group had less neuropathic pain than the control group. The degree of pain was relieved and the duration was shortened significantly. Conclusion The small diameter artificial nerve conduit can effectively protect the digital nerve subjected to crush injury, prevent adhesion of the impaired nerve and its surrounding tissue, reduce compression of the scar tissue, and relieve the degree of pain and decrease the incidence of neuropathic pain. Key words: Hand injuries; Treatment outcome; Artificial nerve canal; Neuropathic pain