From the Research
Treatment Options for Traumatic Digital Neuropathy
Traumatic digital neuropathy, also known as nerve damage affecting the digits, can be treated with various surgical options. The goal of these treatments is to improve or restore sensation and decrease the risk of painful traumatic neuroma formation.
Surgical Treatment Options
- Tension-free end-to-end digital nerve repair or reconstruction under loupe or microscope magnification are surgical treatment options for lacerated digital nerves 1
- Different techniques for primary repair have been described, including epineurial sutures, nerve "glues" including fibrin-based gels, biologic or synthetic absorbable or nonabsorbable nerve wraps or conduits, or a combination of these materials 1
- Nerve allograft and autograft provide similar results and are both better options than conduit reconstruction when there is a gap or defect in the nerve and primary repair is not feasible 1, 2
- Autograft repair was statistically superior to all other forms of repair for static 2-point discrimination (S2PD) outcomes, and allograft trended higher than neurorrhaphy and conduit repair, but results were not statistically significant 2
Factors Affecting Recovery
- Age, the size of the gap, and the type of injury are factors that may affect recovery 3
- The type of injury has an impact on the postoperative outcome of neurorrhaphy 3
- Complications reported in the studies were mainly neuroma, cold sensitivity, paresthesia, postoperative infection, and pain 3
Outcomes of Surgical Repair
- A systematic review of the outcomes of digital nerve repair in adults published in 2019 showed that the average percentage of patients who had undergone repair and reported a recovery to Highet grade 4 was 24% (range, 6% to 60%) 1, 4
- The rate of adverse events was comparable between the operatively and nonoperatively treated patients, with complications including neuromas, hyperesthesia, and infection 1, 4