Hand: Peripheral Nerve

Muscle-in-vein Nerve Guide for Secondary Reconstruction in Digital Nerve Lesions

Ignazio M, Adolfo V (Istituto Clinico Città di Brescia–Gruppo San Donato, Italy) J Hand Surg 35A:1418-1426, 2010^§

Abstract

Purpose

Although vein conduits filled with fresh skeletal muscle have been used to bridge nerve defects both experimentally and clinically with good results, this approach has never been considered a valuable tool for reconstruction of nerve defects, and the technique has been abandoned. The purpose of this study was to evaluate the application of muscle-in-vein conduits for secondary digital nerves reconstruction, with particular emphasis on the surgical technique and results.

Methods

We present a retrospectively selected consecutive series of 21 digital nerve defects in 17 patients who were treated with vein conduits filled with fresh skeletal muscle for secondary nerve reconstruction. After a minimum follow-up of 18 months, all patients were studied with static and moving 2-point discrimination, Semmes–Weinstein monofilament testing, Visual Analog Scale, and Disabilities of the Arm, Shoulder, and Hand questionnaire. Outcome data were stratified according to the American Society for Surgery of the Hand guidelines, the modified Highet and Sander’s criteria, and the Logic Tree.

Results

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