J Lohmeyer1, S Zimmermann, B Sommer, H-G Machens, T Lange, P Mailänder. 1. Abteilung für Plastische, Hand- und Wiederherstellungschirurgie, Intensiveinheit für Schwerbrandverletzte, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck. joern.lohmeyer@uni-luebeck.de
Abstract
BACKGROUND: The nerve autograft is the gold standard for the reconstruction of peripheral nerve defects. In short gaps, nerve repair by means of tubulization has become an alternative. This technique is discussed based on the current literature and our own experience. PATIENTS AND METHODS: Nerve reconstruction by means of tubulization was performed in 11 patients. Nerve gaps in the hand of up to 18 mm were reconstructed. Sensibility was assessed using static and dynamic two point discrimination (s-, d2PD) and monofilament testing 3, 6 and 12 months postoperatively. RESULTS: Three out of 11 patients complained of a temporary foreign body sensation in the area of the implant; this was persistent in one case. Four out of six patients showed excellent results with s2PD of <or=7 mm (Highet S4) assessed 12 months postoperatively. One patient regained no (s2PD>15 mm, S0), another poor sensibility (s2PD 15 mm, S3). D2PD and monofilament testing confirmed these results. CONCLUSIONS: Nerve reconstruction by means of tubulization seems to be a suitable method for certain indications in the reconstruction of short defects of digital and palmar nerves. Donor site morbidity can be avoided. Similarly to nerve transplantation, the operation requires microsurgical skills.
BACKGROUND: The nerve autograft is the gold standard for the reconstruction of peripheral nerve defects. In short gaps, nerve repair by means of tubulization has become an alternative. This technique is discussed based on the current literature and our own experience. PATIENTS AND METHODS: Nerve reconstruction by means of tubulization was performed in 11 patients. Nerve gaps in the hand of up to 18 mm were reconstructed. Sensibility was assessed using static and dynamic two point discrimination (s-, d2PD) and monofilament testing 3, 6 and 12 months postoperatively. RESULTS: Three out of 11 patients complained of a temporary foreign body sensation in the area of the implant; this was persistent in one case. Four out of six patients showed excellent results with s2PD of <or=7 mm (Highet S4) assessed 12 months postoperatively. One patient regained no (s2PD>15 mm, S0), another poor sensibility (s2PD 15 mm, S3). D2PD and monofilament testing confirmed these results. CONCLUSIONS: Nerve reconstruction by means of tubulization seems to be a suitable method for certain indications in the reconstruction of short defects of digital and palmar nerves. Donor site morbidity can be avoided. Similarly to nerve transplantation, the operation requires microsurgical skills.
Authors: T Toba; T Nakamura; A K Lynn; K Matsumoto; S Fukuda; M Yoshitani; Y Hori; Y Shimizu Journal: Int J Artif Organs Date: 2002-03 Impact factor: 1.595
Authors: Felix J Paprottka; Petra Wolf; Yves Harder; Yasmin Kern; Philipp M Paprottka; Hans-Günther Machens; Jörn A Lohmeyer Journal: Plast Surg Int Date: 2013-07-30