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Tubular versus conventional repair of median and ulnar nerves in the human forearm : early results from a prospective, randomized, clinical study

Lundborg, G LU ; Rosén, B LU ; Dahlin, L LU ; Danielsen, N LU and Holmberg, J LU (1997) In The Journal of hand surgery 22(1). p.99-106
Abstract

Injury to a peripheral nerve is followed by local synthesis and release of neurotrophic factors of importance for the regeneration process. This concept was adopted for repair of transected human median and ulnar nerves in the forearm. As an alternative to conventional microsurgical repair of the nerve trunk, silicone tubes of appropriate size were used to enclose the injury zone, intentionally leaving a gap measuring 3-4 mm between the nerve ends inside the tube. The early results from a prospective, randomized, clinical study comparing this principle with conventional microsurgical technique for repair of human median and ulnar nerves, is presented. Eighteen patients (14 men and 4 women), aged 12-72 (mean, 29.5) years, were randomized... (More)

Injury to a peripheral nerve is followed by local synthesis and release of neurotrophic factors of importance for the regeneration process. This concept was adopted for repair of transected human median and ulnar nerves in the forearm. As an alternative to conventional microsurgical repair of the nerve trunk, silicone tubes of appropriate size were used to enclose the injury zone, intentionally leaving a gap measuring 3-4 mm between the nerve ends inside the tube. The early results from a prospective, randomized, clinical study comparing this principle with conventional microsurgical technique for repair of human median and ulnar nerves, is presented. Eighteen patients (14 men and 4 women), aged 12-72 (mean, 29.5) years, were randomized to either tubulization (11 cases) or conventional microsurgical repair (7 cases). A battery of tests for sensory and motor functions of the hand were carried out at regular intervals for up to 1 year after surgery. The results show no difference between the both techniques, with the exception of perception of touch, which showed a significant difference (p < .05) at the 3-month checkup in favor of the tubulization technique. At re-exploration 11 months after the initial procedure (1 case), the former gap was replaced by regenerated nerve tissue in direct continuity with the proximal and distal parts of the nerve trunk, the exact level of the former injury being impossible to identify. Study data demonstrate an intrinsic capacity of human major nerve trunks to reconstruct themselves in a preformed space when an optimal environment is offered and the surgical trauma is minimized.

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organization
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Contribution to journal
publication status
published
subject
keywords
Adolescent, Adult, Aged, Child, Female, Follow-Up Studies, Forearm, Hand, Humans, Intubation, Male, Median Nerve, Microsurgery, Middle Aged, Motor Skills, Nerve Growth Factors, Nerve Regeneration, Prospective Studies, Sensation, Silicones, Suture Techniques, Touch, Ulnar Nerve, Wound Healing, Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
in
The Journal of hand surgery
volume
22
issue
1
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:0030932923
ISSN
0363-5023
DOI
10.1016/S0363-5023(05)80188-1
language
English
LU publication?
yes
id
ef25efb5-baa5-4351-8fd5-4dc147455a0a
date added to LUP
2017-10-13 13:29:05
date last changed
2017-11-29 12:02:32
@article{ef25efb5-baa5-4351-8fd5-4dc147455a0a,
  abstract     = {<p>Injury to a peripheral nerve is followed by local synthesis and release of neurotrophic factors of importance for the regeneration process. This concept was adopted for repair of transected human median and ulnar nerves in the forearm. As an alternative to conventional microsurgical repair of the nerve trunk, silicone tubes of appropriate size were used to enclose the injury zone, intentionally leaving a gap measuring 3-4 mm between the nerve ends inside the tube. The early results from a prospective, randomized, clinical study comparing this principle with conventional microsurgical technique for repair of human median and ulnar nerves, is presented. Eighteen patients (14 men and 4 women), aged 12-72 (mean, 29.5) years, were randomized to either tubulization (11 cases) or conventional microsurgical repair (7 cases). A battery of tests for sensory and motor functions of the hand were carried out at regular intervals for up to 1 year after surgery. The results show no difference between the both techniques, with the exception of perception of touch, which showed a significant difference (p &lt; .05) at the 3-month checkup in favor of the tubulization technique. At re-exploration 11 months after the initial procedure (1 case), the former gap was replaced by regenerated nerve tissue in direct continuity with the proximal and distal parts of the nerve trunk, the exact level of the former injury being impossible to identify. Study data demonstrate an intrinsic capacity of human major nerve trunks to reconstruct themselves in a preformed space when an optimal environment is offered and the surgical trauma is minimized.</p>},
  author       = {Lundborg, G and Rosén, B and Dahlin, L and Danielsen, N and Holmberg, J},
  issn         = {0363-5023},
  keyword      = {Adolescent,Adult,Aged,Child,Female,Follow-Up Studies,Forearm,Hand,Humans,Intubation,Male,Median Nerve,Microsurgery,Middle Aged,Motor Skills,Nerve Growth Factors,Nerve Regeneration,Prospective Studies,Sensation,Silicones,Suture Techniques,Touch,Ulnar Nerve,Wound Healing,Clinical Trial,Comparative Study,Journal Article,Randomized Controlled Trial,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {1},
  pages        = {99--106},
  publisher    = {Elsevier},
  series       = {The Journal of hand surgery},
  title        = {Tubular versus conventional repair of median and ulnar nerves in the human forearm : early results from a prospective, randomized, clinical study},
  url          = {http://dx.doi.org/10.1016/S0363-5023(05)80188-1},
  volume       = {22},
  year         = {1997},
}