Chao Chen1, Peifu Tang, Xu Zhang. 1. Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, Hebei, People's Republic of China. ts_chenchao@163.com
Abstract
PURPOSE: To report reconstruction of proper digital nerve (PDN) defects using a nerve transfer from the dorsal branch of the uninjured PDN and compare the results with those of nerve grafting. METHODS: A retrospective study was conducted with 17 consecutive patients who had PDN defects treated with a nerve transfer from the dorsal branch of the PDN from May 2007 to July 2009. The patients included 14 male and 3 female patients, with an average age of 32 years. There were 21 PDN defects in 20 fingers. The injured fingers included 5 index, 8 long, 5 ring, and 2 little fingers. The average length of the nerve defects was 2.3 cm (range, 1.4-3.5 cm). The uninjured dorsal branch of the other PDN of the same digit or the dorsal branch of the PDN of the adjacent digit was selected as a donor nerve. Neurorrhaphy was performed between the dorsal branch and the distal end of the PDN. For comparison, we collected a series of 31 patients with PDN defects treated with conventional sural nerve grafting. RESULTS: At a mean follow-up of 25 months (range, 20-26 mo), the mean static 2-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) scores on the finger pulp of the nerve transfer were 6.4 mm and 3.63, respectively. In the comparison group (mean follow-up, 23 mo; range, 19-27 mo), the mean static 2PD and SWM scores on the pulp were 9.2 mm and 4.10 mm. Significant differences were found in static 2PD and SWM results. CONCLUSIONS: Nerve transfer with the digital nerve dorsal sensory branch was useful for reconstruction of the PDN defect located between the proximal interphalangeal joint and the common digital nerve bifurcation. Sensory recovery using local nerve transfer was superior to conventional sural nerve graft. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
PURPOSE: To report reconstruction of proper digital nerve (PDN) defects using a nerve transfer from the dorsal branch of the uninjured PDN and compare the results with those of nerve grafting. METHODS: A retrospective study was conducted with 17 consecutive patients who had PDN defects treated with a nerve transfer from the dorsal branch of the PDN from May 2007 to July 2009. The patients included 14 male and 3 female patients, with an average age of 32 years. There were 21 PDN defects in 20 fingers. The injured fingers included 5 index, 8 long, 5 ring, and 2 little fingers. The average length of the nerve defects was 2.3 cm (range, 1.4-3.5 cm). The uninjured dorsal branch of the other PDN of the same digit or the dorsal branch of the PDN of the adjacent digit was selected as a donor nerve. Neurorrhaphy was performed between the dorsal branch and the distal end of the PDN. For comparison, we collected a series of 31 patients with PDN defects treated with conventional sural nerve grafting. RESULTS: At a mean follow-up of 25 months (range, 20-26 mo), the mean static 2-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) scores on the finger pulp of the nerve transfer were 6.4 mm and 3.63, respectively. In the comparison group (mean follow-up, 23 mo; range, 19-27 mo), the mean static 2PD and SWM scores on the pulp were 9.2 mm and 4.10 mm. Significant differences were found in static 2PD and SWM results. CONCLUSIONS: Nerve transfer with the digital nerve dorsal sensory branch was useful for reconstruction of the PDN defect located between the proximal interphalangeal joint and the common digital nerve bifurcation. Sensory recovery using local nerve transfer was superior to conventional sural nerve graft. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.