COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
Add like
Add dislike
Add to saved papers

A prospective randomized study comparing woven polyglycolic acid and autogenous vein conduits for reconstruction of digital nerve gaps.

PURPOSE: The optimal management of a nerve gap within the fingers remains an unanswered question in hand surgery. The purpose of this study was to compare the sensory recovery, cost, and complication profile of digital nerve repair using autogenous vein and polyglycolic acid conduits.

METHODS: We enrolled patients undergoing repair of digital nerve injuries with gaps precluding primary repair. The minimum gap that was found to preclude primary repair was 4 mm. Each nerve repair was randomized to the type of nerve repair with either a woven polyglycolic acid conduit or autogenous vein. Time required for repair was recorded. We performed sensory testing, consisting of static and moving 2-point discrimination, at 6 and 12 months after repair. We compared patient factors between the 2 groups using chi-square and Student's t-test. We compared sensory recovery between the 2 groups at each time point using Student's t-test and compared time and cost of repair.

RESULTS: We enrolled 42 patients with 76 nerve repairs. Of these, 37 patients (representing 68 repairs) underwent sensory evaluation at the 6-month time point. The median age in this group was 35 years. We repaired 36 nerves with synthetic conduit and 32 with vein. Nerve gaps ranged from 4 to 25 mm (mean, 10 mm). Study groups were not significantly different regarding age, time to repair, gap length, medical history, smoking history, or worker's compensation status. Time to harvest the vein was longer but the average cost of materials and surgery in the vein group was $1,220, compared with $1,269 for synthetic conduit repairs. These differences were not statistically significant. Mean static and moving 2-point discrimination at 6 months for the synthetic conduit group were 8.3 ± 2.0 and 6.6 ± 2.3, respectively, compared with 8.5 ± 1.8 and 7.1 ± 2.2 for the vein group. Values at 12 months for the synthetic conduit group were 7.5 ± 1.9 and 5.6 ± 2.2, compared with 7.6 ± 2.6 and 6.6 ± 2.9 for the vein group. These differences were not statistically significant. Smokers and worker's compensation patients had a worse sensory recovery at 12 months postrepair. There were 2 extrusions in the synthetic conduit group requiring reoperation; however, the difference in extrusion rate was not found to be statistically significant.

CONCLUSIONS: Sensory recovery after digital nerve reconstruction with autogenous vein conduit was equivalent to that using polyglycolic acid conduit, with a similar cost profile and fewer postoperative complications.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app