Nerve Repair Research Articles

Psychology of nerve injury, repair, and recovery: a systematic review.

Peripheral nerve injuries (PNIs) are associated with significant physical and psychological challenges, impacting both functional recovery and quality of life. Despite the physical focus of traditional treatments, psychological factors play a crucial role in the outcomes of PNI repair and recovery. This systematic review aims to evaluate the impact of psychological and social factors on the repair and recovery of peripheral nerve injuries. A comprehensive literature search was conducted in PubMed/Medline, EMBASE, and Cochrane databases, covering studies from January 1985 to December 2022. A total of 36,190 records were identified, and after screening with Rayyan AI and applying inclusion criteria, 111 articles were selected for review. The review highlights that pre-existing psychological conditions, as well as psychological responses to the injury and treatment, significantly influence recovery outcomes in PNI patients. Psychological interventions, when integrated into standard care, may improve functional recovery and quality of life. Psychosocial factors are critical in the management of PNIs and should be incorporated into treatment algorithms to enhance patient outcomes. Future research should focus on developing and integrating psychological support strategies in PNI treatment protocols.

Combining external physical stimuli and nanostructured materials for upregulating pro-regenerative cellular pathways in peripheral nerve repair.

Peripheral nerve repair remains a major clinical challenge, particularly in the pursuit of therapeutic approaches that ensure adequate recovery of patient's activity of daily living. Autografts are the gold standard in clinical practice for restoring lost sensorimotor functions nowadays. However, autografts have notable drawbacks, including dimensional mismatches and the need to sacrifice one function to restore another. Engineered nerve guidance conduits have therefore emerged as promising alternatives. While these conduits show surgical potential, their clinical use is currently limited to the repair of minor injuries, as their ability to reinnervate limiting gap lesions is still unsatisfactory. Therefore, improving patient functional recovery requires a deeper understanding of the cellular mechanisms involved in peripheral nerve regeneration and the development of therapeutic strategies that can precisely modulate these processes. Interest has grown in the use of external energy sources, such as light, ultrasound, electrical, and magnetic fields, to activate cellular pathways related to proliferation, differentiation, and migration. Recent research has explored combining these energy sources with tailored nanostructured materials as nanotransducers to enhance selectivity towards the target cells. This review aims to present the recent findings on this innovative strategy, discussing its potential to support nerve regeneration and its viability as an alternative to autologous transplantation.

A nanofibrous polycaprolactone/collagen neural guidance channel filled with sciatic allogeneic schwann cells and platelet-rich plasma for sciatic nerve repair.

Sciatic nerve damage, a common condition affecting approximately 2.8% of the US population, can lead to significant disability due to impaired nerve signal transmission, resulting in loss of sensation and motor function in the lower extremities. In this study, a neural guidance channel was developed by rolling a nanofibrous scaffold produced via electrospinning. The scaffold's microstructure, biocompatibility, biodegradation rate, porosity, mechanical properties, and hemocompatibility were evaluated. Platelet-rich plasma (PRP) activated with 30,000 allogeneic Schwann cells (SCs) was injected into the lumen of the channels following implantation into a rat model of sciatic nerve injury. Recovery of motor function, sensory function, and muscle re-innervation was assessed using the sciatic function index (SFI), hot plate latency time, and gastrocnemius muscle wet weight loss. Results showed mean hot plate latency times of Autograft: 7.03, PCL/collagen scaffolds loaded with PRP and SCs (PCLCOLPRPSCs): 8.34, polymer-only scaffolds (PCLCOL): 10.66, and untreated animals (Negative Control): 12.00. The mean SFI values at week eight were Autograft: -49.30, PCLCOLPRPSCs: -64.29, PCLCOL: -75.62, and Negative Control: -77.14. The PCLCOLPRPSCs group showed a more negative SFI compared to the Autograft group but performed better than both the PCLCOL and Negative Control groups. These findings suggest that the developed strategy enhanced sensory and functional recovery compared to the negative control and polymer-only scaffold groups.

A hierarchical hydrogel dressing with continuous biochemical gradient for immunoregulation, nerve repair and angiogenesis of refractory diabetes wounds

The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation, M1 macrophage aggregation, and high glucose levels in the microenvironment. Previous studies have demonstrated that immunomodulatory hydrogel dressings can facilitate diabetic wound healing. However, current immunomodulatory hydrogels require costly and complex treatments such as cell therapy and cytokines. Herein, a hierarchical hydrogel dressing with continuous biochemical gradient based on glycyrrhizic acid (GA) was constructed to modulate immunomodulatory processes in diabetic wounds. The hydrogels present many desirable features, such as tunable mechanical properties, broad antibacterial ability, outstanding conductive, transparent, and self-adhesive properties. The resultant hydrogel can promote diabetic wound healing by preventing bacterial infection, promoting macrophage polarization, improving the inflammatory microenvironment, and inducing angiogenesis and neurogenesis. Furthermore, electrical stimulation (ES) can further promote the healing of chronic diabetic wounds, providing valuable guidance for relevant clinical practice.

Quercetin Alleviates Diabetic Peripheral Neuropathy by Regulating Axon Guidance Factors and Inhibiting the Rho/ROCK Pathway in vivo and in vitro.

The axon guidance factors and Rho/ROCK pathway play crucial roles in axon protection and nerve repair and has been implicated in the development of diabetic peripheral neuropathy (DPN). This study investigates the protective effects of quercetin against DPN, focusing on axon guidance factors and Rho/ROCK pathway. DPN was induced by intraperitoneal injection of streptozotocin (STZ) to Sprague-Dawley rats. The DPN model rats were allocated into three groups and administered quercetin at two different doses (30 mg/kg/day and 60 mg/kg/day) or a placebo. Concurrently, healthy rats were divided into two groups and administered either a placebo or quercetin (60 mg/kg/day). Administration was initiated 8weeks post-STZ injection and continued for a duration of six weeks. To assess quercetin's neuroprotective effects, biochemical analyses, neurological function tests (mechanical threshold, thermal response latency, motor nerve conduction velocity), and morphological assessments via transmission electron microscopy were conducted. Immunofluorescence and immunohistochemical assays were performed on sciatic nerve tissue and high glucose-induced RSC96 rat Schwann cells to explore quercetin's pharmacological effects on DPN. Quercetin exhibited neuroprotective effects on both DPN rats and RSC96 cells exposed to high-glucose. A six-week administration of quercetin at both doses significantly improved the peripheral neurological functions and alleviated the pathological changes in sciatic nerve of DPN rats (P<0.05). Mechanistically, quercetin markedly upregulated the expressions of axonal growth factors, Slit-2 and Netrin-1 in vivo and in vitro (P<0.05), while inhibiting the aberrant activation of Rho/ROCK signaling pathway in the sciatic nerve of DPN rats. Our findings suggest that quercetin improves DPN through a novel mechanism, indicating its potential as a therapeutic agent for DPN therapy.

Dramatic Neurologic Recovery after ORIF of the Humeral Shaft with Anterior Transposition and Primary Repair of the Radial Nerve – Case Report

Dramatic Neurologic Recovery after ORIF of the Humeral Shaft with Anterior Transposition and Primary Repair of the Radial Nerve – Case Report

A 3D Nerve Guidance Conduit Surface With a Wrinkled Protein Coating Toward Peripheral Nerve Injury Repair

ABSTRACTPeripheral nerve injuries (PNIs) resulting in myelin breakdown and axonal degeneration at both the proximal and distal nerve stumps are major clinical concerns that can induce functional loss and diminished quality of life. In biomaterials science, considerable attention has been given to artificial nerve guidance conduits (NGCs), since the engineered tubular structures have the potential to supply a supportive nerve microenvironment to longitudinally align the regenerating axons for bridging the injured nerve sites. Although NGCs may become promising alternatives to nerve autografts, the fabrication approaches available to incorporate directional cues for dictating neuronal behavior and nerve reconnection have been limited to conventional micro/nano‐fabrication techniques that are complex and time‐consuming due to manual processing steps. Thus, our goal here was to develop a simple manufacturing approach for introducing topographical cues onto NGCs. To achieve this goal, we used an established mechanically actuated silk wrinkling approach to create topographically functionalized surfaces as a potential NGC material platform for guided directional alignment of neurons. We 3D‐printed thermo‐responsive shape‐memory polymer (SMP)‐based NGCs that can produce silk fibroin (SF)‐wrinkled topographies on the micro and nano‐meter length scale. Since SF is a commonly used biomaterial surface coating with excellent neuro‐compatibility, we studied the ability to develop NGCs that can autonomously actuate silk wrinkles upon heat‐induced contraction of the SMP and evaluated the effects of the topographically functionalized construct on neuronal behavior. Using an immortalized dorsal root ganglion neuronal cell line, we found that the silk‐wrinkled conduits displayed high neuronal viability and adhesion compared to uncoated conduits and tissue‐culture polystyrene controls. We also found that the wrinkled conduits enabled the neurons to elongate and align parallel to the direction of the wrinkled topography. Longer neurite extension was also observed on the wrinkled conduits compared to their respective controls. These findings demonstrate the potential for functional wrinkled protein coatings to provide directional cues in the fabrication of artificial NGCs for peripheral nerve repair.

Reprogramming metabolic microenvironment for nerve regeneration via waterborne polylactic acid-polyurethane copolymer scaffolds

Cell metabolism, as the key driver of inflammation, revascularization and even subsequent tissue regeneration, is controlled by and also conversely influenced by signal transduction. Incorporation of cell metabolism into tissue engineering research holds immense potential for in-situ treatment repair and further understanding of the host-biomaterial cues in body response. In this study, an anti-inflammatory waterborne polyurethane scaffold incorporated with poly-l-lactic acid (PLLA) block was served to repair nerve injuries (LAx-WPU). Lactate was released through the degradation of LAx-WPU scaffolds, and the content increased with the addition of PLLA block over the degradation times. Thenceforth, the production of adenosine triphosphate (ATP) in primary neurons and neuronal axon growth were achieved by taking up lactate through monocarboxylate transporters (MCT2) for energy metabolism under glucose-free environment treated with LAx-WPU degradation solution. After LAx-WPU was implanted to repair brain nerve defects in rats, filamentous neurons elongation, rapid vascularization, and nerve tissue regeneration were realized up to 28 days with the positive expression of microtubule-associated protein (MAP2), β-tubulin (Tuj1), and platelet endothelial cell adhesion molecule (CD31) in the scaffolds. Results highlighted that the LAx-WPU scaffolds up-regulated not only the ATP-ADP-AMP purine metabolism compounds to mainly bridge neuroactive ligand-receptor interaction genes, cAMP pathway genes, and calcium pathway genes for neurocytes but also the ATP-GMP purine metabolism to angiogenesis in Gene Ontology (GO) analysis. Further analysis in reverse showed axonal regeneration is restrained by the inhibition of MCT2, proving LAx-WPU promoted nerve repair depended on lactate for energy. Therefore, LAx-WPU scaffolds construct an expected way to modulate the metabolic microenvironment for inducing nerve regeneration by intrinsic biomaterial metabolism cues without any bioactive factors.

034. Arterials Re-Repair with Saphenous Vein Graft for Acute Limb Ischemia in Previously Repaired Patient: A Complicated Case Report

Background: Acute upper extremity ischemia following trauma is a potentially limb-threatening condition that requires prompt diagnosis and intervention. We presented a complicated case of a patient who had previously undergone repair for his left arm but developed post-operative acute limb ischemia. Case: A 51-year-old male presented to the emergency room (ER) with acute numbness in his left hand. He previously underwent a muscle, artery, and nerve repair for his left arm due to a wooden impaled wound. Other comorbidities were denied, and the patient’s hemodynamics were stable. Physical examination showed left antebrachial covered with Backslab, tenderness upon palpation, and limited range of motion. The left fingers’ oxygen saturation were lower (90-93%). Left antebrachial imaging revealed no fracture. Vascular exploration, thrombectomy, and left radial and ulnar arteries repair using the saphenous vein graft were performed. The post-surgical outcome was great, and the numbness began to fade away. Left fingers’ oxygen saturation rose dramatically (94-95%). The patient was satisfied with the outcomes, followed by discharge from the hospital. Conclusion: Prompt recognition and surgical intervention of vascular trauma complications effectively restore function and alleviate symptoms.

Alginate Use in Orthopedics and Peripheral Nerve Repair: A Systematic Review.

The use of alginate, a derivative of seaweed, has been proposed for multiple orthopedic indications. We aimed to review the current use of alginate in orthopedics and to focus on the future applications of alginate for peripheral nerve repair. A comprehensive literature search was performed to identify biomechanical, laboratory, animal, and human studies where alginate has been utilized for orthopedic or nerve repair indications. A systematic review of orthopedic indications was conducted for safety and efficacy, and a specific focus was placed on alginate for use in peripheral nerve repair and reconstruction. Thirty-two studies were identified. Alginate has a strong history and safety profile for usage in orthopedic surgery. Its primary usage has been for the repair of articular cartilage, although it has also been used for disc regeneration of the lumbar spine and for cushioning joints in osteoarthritis. The primary indication in peripheral nerve repair is to create an environment that encourages Schwann cell migration and repair in nerve injuries while blocking fibrotic scar tissue formation by inhibiting the activity of fibroblasts. Alginate hydrogel may serve as a potential conduit for nerve regeneration in nerve injuries with small to medium-sized gaps.

Nanozyme Hydrogels Promote Nerve Regeneration in Spinal Cord Injury by Reducing Oxidative Stress.

Inhibiting secondary cell death and promoting neuronal regeneration are critical for nerve repair after spinal cord injury (SCI). The excessive accumulation of reactive oxygen species (ROS) after SCI causes cell death and induces apoptosis. These reactions further increase the level of ROS production, leading to a vicious cycle of spinal cord tissue damage. Therefore, intervention targeting ROS is a potential therapeutic approach to improve the recovery of locomotor function after SCI. In this study, we designed and synthesized a nanozyme hydrogel delivery system loaded with multiple drugs, LA/Me/Se NPs-h. LA/Me/Se NPs-h exhibited a satisfactory size distribution and excellent stability, enhancing the bioavailability of therapeutic drugs. Moreover, we explored the antioxidant and protective effects of LA/Me/Se NPs-h against oxidative stress-induced cell damage caused by ROS production after SCI in vitro. In the mice SCI model, the Basso mouse scale and gait analysis showed that LA/Me/Se NPs-h significantly promoted the recovery of locomotor function after SCI. The histological and immunofluorescence results of the injury site revealed that LA/Me/Se NPs-h upregulated the expression of GFAP, NF-200, and superoxide dismutase in spinal cord lesion, reduced caspase-3 expression, improved spinal cord continuity, reduced lesion cavity, and inhibited the axonal demyelination. Consequently, LA/Me/Se NPs-h increased the activity of antioxidant enzymes and reduced neuronal apoptosis by reducing oxidative stress and ultimately promoted nerve regeneration. Taken together, this study demonstrated promising nanozyme hydrogels and provided an effective therapeutic strategy for SCI and other ROS-related diseases.

Dual Role of Ibuprofen and Indomethacin in Promoting Peripheral Nerve Regeneration In Vitro.

Peripheral nerve injuries (PNI) can result in significant losses of motor and sensory function. Although peripheral nerves have an innate capacity for regeneration, restoration of function after severe injury remains suboptimal. The gold standard for peripheral nerve regeneration (PNR) is autologous nerve transplantation, but this method is limited by the generation of an additional surgical site, donor-site morbidity, and neuroma formation at the site of harvest. Although targeted drug compounds have the potential to influence axonal growth, there are no drugs currently approved to treat PNI. Therefore, we propose to repurpose commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) to enhance PNR, facilitating easier clinical translation. Additionally, calcium signaling plays a crucial role in neuronal connectivity and regeneration, but how specific drugs modulate this process remains unclear. We developed an in vitro hollow channel collagen gel platform that successfully supports neuronal network formation. This study evaluated the effects of commonly used NSAIDs, namely ibuprofen and indomethacin, in our in vitro model of axonal growth, regeneration, and calcium signaling as potential treatments for PNI. Our results demonstrate enhanced axonal growth and regrowth with both ibuprofen and indomethacin, suggesting a positive influence on PNR. Further, these drugs showed enhanced calcium signaling dynamics, which we posit is a crucial aspect for nerve repair. Taken together, these findings highlight the potential of ibuprofen and indomethacin to be used as treatment options for PNI, given their dual capability to promote axonal growth and enhance calcium signaling.

Clinical, Preclinical, and Educational Applications of Robotic-Assisted Flap Reconstruction and Microsurgery: A Systematic Review.

Microsurgery and super-microsurgery allow for highly technical reconstructive surgeries to be performed, with repairs of anatomical areas of less than 1 mm. Robotic-assisted surgery might allow for further advances within microsurgery, providing higher precision, accuracy, and scope to operate in previously inaccessible anatomical areas. However, robotics is not well-established within this field. We provide a summary of the clinical and preclinical uses of robotics within flap reconstruction and microsurgery, educational models, and the barriers to widespread implementation. A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted of PubMed, Medline, and Embase. Preclinical, educational, and clinical articles were included. One thousand five hundred and forty-two articles were screened; 87 articles met the inclusion criteria across flap harvest, flap/vessel pedicle dissection, vascular anastomosis, and nerve repair. The literature presents several potential benefits to the surgeon and patient such as high cosmetic satisfaction, minimally invasive access with reduced scarring (flap harvest), and low complication rates. Lack of haptic feedback was reported by authors to not impede the ability to perform vessel anastomosis; however, this required further investigation. A steep learning curve was identified, particularly for microsurgeons embarking upon robotic-assisted surgery. Robotic-assisted surgery can potentially enhance microsurgery and flap reconstruction, with feasibility demonstrated within this review, up to anastomosis of 0.4 mm in diameter. However, there is a lack of sufficiently powered comparative studies, required to strengthen this statement. To increase accessibility to robotic surgery for plastic and reconstructive surgeons, educational opportunities must be developed with standardized assessment of skill acquisition.

End to End Sciatic Nerve Repair at Different Angles of Attachment: in Albino Rat Experimental Model

End to End Sciatic Nerve Repair at Different Angles of Attachment: in Albino Rat Experimental Model

Toll-Like Receptor 4 (TLR4) Promotes DRG Regeneration and Repair after Sciatic Nerve Injury via the ERK-NF-kB Pathway.

Previously, we found that the expression of Toll-like receptor 4 (TLR4) is altered after sciatic nerve injury, and its differential expression plays a key role in recovery. However, the mechanisms by which TLR4 affects neuronal function in the dorsal root ganglion (DRG) have not been completely evaluated. The objective is to determine TLR4 expression in DRG tissues after sciatic neural injury and exploring the effects of TLR4 knockdown and overexpression in the DRG on neuronal function and nerve regeneration in rats in vivo and in vitro. We established a model of nerve injury and utilized molecular biology and cell biology experiments to explore the molecular mechanisms by which TLR4 in the DRG affects sciatic nerve restoration and regeneration after injury. Verified the localization of TLR4 in DRG neurons. Investigated pathways that related to apoptosis or nerve regeneration by which TLR4 regulates the function of DRG neurons. TLR4 expression was upregulated in the DRG tissues of rats after sciatic nerve injury. TLR4 overexpression promoted axon regeneration and inhibited apoptosis in DRG neurons. TLR4 promoted the regeneration of axons and the recovery of motor and sensory functions in the sciatic nerve after injury in vivo, and the data showed that TLR4 may regulate the function of DRG neurons and promote nerve repair and regeneration through the ERK and NF-κB signaling pathways in vivo and ex vivo. The study suggests that TLR4 may regulate the function of DRG neurons and promote nerve regeneration by affecting the ERK and NF-κB signaling pathways.

An injectable thermosensitive pluronic F127 loaded-nanohydroxyapatite / Polydopamine for promoting sciatic nerve repair after crush injury

Peripheral nerve injury (PNI) remains an urgent issue due to its huge financial burden and high rate of disability. Here, an injectable HAP/PDA thermosensitive pluronic F-127 (PF-127) hydrogel is proposed for peripheral nerve repair. We investigated the surface characteristics of HAP/PDA and evaluated biocompatibility, cellular proliferation, differentiation, and apoptosis in vitro. After injecting the hydrogel into the injured site of rats, we recorded the recovery of motor function and judged the degree of nerves through electrophysiological and morphological changes. The hydrogel was found to accelerate the nerve regeneration. Collectively, the HAP/PDA thermosensitive PF-127 hydrogel has potential in promoting sciatic nerve repair.

Neural repair function of osteopontin in stroke and stroke‑related diseases (Review).

Stroke, including hemorrhagic stroke and ischemic stroke, is a common disease of the central nervous system. It is characterized by a high mortality and disability rate and is closely associated with atherosclerosis, hypertension hyperglycemia, atrial fibrillation and unhealthy living habits. The continuous development of surgery and medications has decreased the mortality rate of patients with stroke and has greatly improved the disease prognosis. At present, the direction of clinical treatment and research has gradually shifted to the repair of nerve function after stroke. Osteopontin (OPN) is a widely distributed extracellular matrix protein. Due to its structural characteristics, OPN can be cut and modified into terminal fragments with different functions, which play different roles in various pathophysiological processes, such as formation of tumors, inflammation and autoimmune diseases. It has also become a potential diagnostic and therapeutic marker. In order to comprehensively analyze the specific role of OPN in nerve repair and its relationship with stroke and stroke-related diseases, the following key words were used: 'Osteopontin, stroke, atherosis, neuroplasticity, neural repair'. PubMed, Web of Science and Cochrane articles related to OPN were searched and summarized. The present review describes the OPN structure, isoforms, functions and its neural repair mechanism, and its association with the occurrence and development of stroke and related diseases was explored.

Enhanced Understanding of Facial Nerve Anatomy and Arborization in the Indian Population: Implications for Surgical Procedures.

The anatomy and arborization patterns of the extraparotid facial nerve show considerable variation among different populations, impacting surgical approaches in plastic, head and neck, and ENT surgeries. This study focuses on the Indian population to provide a detailed understanding of these variations, specifically highlighting the Davis type IV arborization pattern's prevalence and its clinical relevance. We conducted a comprehensive dissection of 16 formalin-preserved Indian cadaveric hemifaces. The study meticulously mapped the facial nerve trunk (FNT), its furcation points, and branches. Key anatomical landmarks for locating these nerve structures were identified, including the tip of the mastoid process, the angle of the mandible, and a novel line between the lateral palpebral fissure and otobasion superioris. The most common arborization pattern observed was Davis type IV (31.3%). The study provided precise measurements for locating the FNT and its branches, using identifiable landmarks. These findings facilitate more accurate surgical planning, crucial for procedures involving nerve repair or grafting. This research offers vital insights into the facial nerve anatomy specific to the Indian population, with significant implications for surgical precision and patient outcomes. By establishing reliable anatomical landmarks and elucidating the predominant arborization pattern, the study enhances the understanding of facial nerve behavior during surgical interventions, particularly in the context of facial paralysis treatment and reconstructive surgeries. Due to the small sample size, however, this study only acts as a pilot for further research.

The Effectiveness of High Intensity Laser in Improving Motor Deficits in Patients with Lumbar Disc Herniation.

High-Intensity Laser (HIL) therapy, known for its biostimulatory effects on nerve cell growth and repair, shows promise for improving motor deficits caused by morphopathological changes. This research study aimed to comprehensively assess muscle strength changes through muscle testing, complemented by functional tests evaluating factors contributing to disability in patients with Lumbar Disc Herniation (LDH) and associated motor impairment, following a complex rehabilitation protocol incorporating HIL therapy. A total of 133 individuals with LDH and motor deficits were divided into two groups. Group 1 (n = 66) received HIL therapy followed by standard rehabilitation, while Group 2 (n = 67) underwent only the standard rehabilitation program. Functional parameters, including muscle strength, the ability to walk on tiptoes or heels, and self-assessed fall risk, were monitored. Both groups showed statistically significant improvements in all monitored parameters. A comparative analysis revealed a significant result for the HIL therapy regimen across all indicators. The group undergoing a rehabilitation program with integrated HIL therapy displayed significantly greater improvement in motor deficits, affirming the positive impact of HIL therapy on functional parameters among LDH patients.

Long-term subjective and objective outcomes after digital nerve repair: a cohort study.

Digital nerve injuries are common, but few studies report long-term effects for the individual. The primary aim of this matched-pairs study comparing digital nerve injuries in border digits or central fingers was to investigate hand function 3-10 years after digital nerve repair, assessed using the Mini Sollerman test in 86 patients. Secondary outcomes were sensory function, range of motion, grip strength and patient-reported measures. No significant difference was seen in hand function between the groups, except for lower grip strength in patients with central finger injury. Tactile discrimination was achieved in 87%, with best results among participants aged less than 44 years. Touch perception was measurable in 99%. No statistically significant differences in sensory function were found between the groups. Patient-reported disability was low, with median Quick Disabilities of the Arm, Shoulder and Hand score of 5, but half of the patients reported neuropathic pain. Numbness and cold sensitivity were the symptoms graded worst after digital nerve injury.Level of evidence: III.