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Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different method...

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Autores principales: Paprottka, Felix J., Wolf, Petra, Harder, Yves, Kern, Yasmin, Paprottka, Philipp M., Machens, Hans-Günther, Lohmeyer, Jörn A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745965/
https://www.ncbi.nlm.nih.gov/pubmed/23984064
http://dx.doi.org/10.1155/2013/704589
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author Paprottka, Felix J.
Wolf, Petra
Harder, Yves
Kern, Yasmin
Paprottka, Philipp M.
Machens, Hans-Günther
Lohmeyer, Jörn A.
author_facet Paprottka, Felix J.
Wolf, Petra
Harder, Yves
Kern, Yasmin
Paprottka, Philipp M.
Machens, Hans-Günther
Lohmeyer, Jörn A.
author_sort Paprottka, Felix J.
collection PubMed
description Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-, muscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve reconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997 nerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior to another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve grafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients who underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery outcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique should be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a decision tree for digital nerve repair.
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spelling pubmed-37459652013-08-27 Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review Paprottka, Felix J. Wolf, Petra Harder, Yves Kern, Yasmin Paprottka, Philipp M. Machens, Hans-Günther Lohmeyer, Jörn A. Plast Surg Int Review Article Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-, muscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve reconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997 nerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior to another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve grafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients who underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery outcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique should be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a decision tree for digital nerve repair. Hindawi Publishing Corporation 2013 2013-07-30 /pmc/articles/PMC3745965/ /pubmed/23984064 http://dx.doi.org/10.1155/2013/704589 Text en Copyright © 2013 Felix J. Paprottka et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Paprottka, Felix J.
Wolf, Petra
Harder, Yves
Kern, Yasmin
Paprottka, Philipp M.
Machens, Hans-Günther
Lohmeyer, Jörn A.
Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title_full Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title_fullStr Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title_full_unstemmed Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title_short Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review
title_sort sensory recovery outcome after digital nerve repair in relation to different reconstructive techniques: meta-analysis and systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745965/
https://www.ncbi.nlm.nih.gov/pubmed/23984064
http://dx.doi.org/10.1155/2013/704589
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