Reconstruction of digital nerves with collagen conduits

Abstract

Purpose: Digital nerve reconstruction with a biodegradable conduit offers the advantage of providing nerve reconstruction while providing a desirable environment for nerve regeneration. Many conduit materials have been investigated, but there have been few reports of human clinical trials of purified type I bovine collagen conduits. Methods: We report a prospective study of 22 isolated digital nerve lacerations in 19 patients reconstructed with a bioabsorbable collagen conduit. The average nerve gap measured 12 mm. An independent observer performed the postoperative evaluation, noting the return of protective sensation, static 2-point discrimination, and moving 2-point discrimination, and recording the patient's pain level using a visual analog scale. Minimal follow-up was 12 months and mean follow-up was 20 months after surgery. Results: All patients recovered protective sensation. The mean moving 2-point discrimination and static 2-point discrimination measured 5.0 and 5.2 mm, respectively, for those with measurable recovery at final follow-up visit. Excellent results were achieved in 13 of 22 digits, good results in 3 of 22 digits, and fair results in 6 of 22 digits, and there were no poor results. Reported pain scores at the last postoperative visit were measured universally as 0 on the visual analog scale. Conclusions: Our data suggest that collagen conduits offer an effective method of reconstruction for digital nerve lacerations. This study confirms that collagen conduits reliably provide a repair that restores nerve function for nerve gaps measuring less than 2 cm. Type of study/level of evidence: Therapeutic IV. © 2011 American Society for Surgery of the Hand.