Abstract
Background
Precise approximation of two nerve endings is a major determinant of outcomes following nerve repairs. Despite technical and instrumental advances, approximation of nerve endings remains a challenge in reconstructive surgeries. We designed a new nerve approximator device for precise approximation of nerve endings and evaluated its utility in surgeries of peripheral nerves.
Methods
We conducted a longitudinal study comparing postoperative functional outcomes between patients with peripheral nerve injury undergoing surgical repair by the new approximator device and conventional technique.
Results
A total of 204 nerve trunks were repaired by the new approximator device and 91 nerves by conventional technique. Patients were followed for a median of 30 months. Time required for nerve approximation was significantly reduced with the approximator device (4.5 min vs. 7 min, p < 0.0001). Nerve conduction velocity and tinel sign revealed similar results in both groups. However, grip, pinch and intrinsic muscle strength tests did not differ between the two groups.
Conclusions
Our new nerve approximator device is feasible to use and reduces time of neurorrhaphy in microsurgical nerve repairs with sustained outcomes comparable to the conventional techniques.
Level of Evidence: Level IV, therapeutic study.
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References
Griffin JW, Hogan MV, Chhabra AB, Deal DN (2013) Peripheral nerve repair and reconstruction. J Bone Joint Surg Am 95(23):2144–2151
Geuna S, Perroteau I, Tos P, Battiston B (2013) Peripheral nerve repair is no longer a matter of surgical reconstruction only. Int Rev Neurobiol 109:xi–xii
Reid AJ, de Luca AC, Faroni A, Downes S, Sun M, Terenghi G et al (2013) Long term peripheral nerve regeneration using a novel PCL nerve conduit. Neurosci Lett 544:125–130
Jeans LA, Gilchrist T, Healy D (2007) Peripheral nerve repair by means of a flexible biodegradable glass fibre wrap: a comparison with microsurgical epineurial repair. J Plast Reconstr Aesthet Surg 60(12):1302–1308
Bayramicli M, Gurunluoglu R, Yilmaz B, Numanoglu A (1997) Nerve and tendon approximator. J Hand Surg [Am] 22(4):753–754
Dvali L, Mackinnon S (2007) The role of microsurgery in nerve repair and nerve grafting. Hand Clin 23(1):73–81
Kamath J, Bhardwaj P (2005) A simple, inexpensive nerve approximator. Plast Reconstr Surg 116(6):1721–1723
LaLonde DH (1989) A tendon approximator. Plast Reconstr Surg 83(5):912–913
Yazar M, Basaran K, Guven E, Ugurlu AM, Topalan M (2009) A new approximator used in microvascular anastomosis. Microsurgery 29(7):588–591
Schreuders TA, Roebroeck ME, Jaquet JB, Hovius SE, Stam HJ (2004) Long-term outcome of muscle strength in ulnar and median nerve injury: comparing manual muscle strength testing, grip and pinch strength dynamometers and a new intrinsic muscle strength dynamometer. J Rehabil Med 36(6):273–278
Ruijs AC, Jaquet JB, Kalmijn S, Giele H, Hovius SE (2005) Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair. Plast Reconstr Surg 116(2):484–494, discussion 95–6
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Ethical Standards
This study has been approved by the Institutional Review Board of Hazrat Fatemeh Hospital and was conducted in accordance with Declaration of Helsinki Statements. All patients gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.
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Forootan, K.S., Karimi, H. & Forootan, Ns.S. A new device for nerve approximation in traumatic injuries of extremities. Eur J Plast Surg 37, 497–502 (2014). https://doi.org/10.1007/s00238-014-0975-z
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DOI: https://doi.org/10.1007/s00238-014-0975-z