Logo image
Back
Digital Nerve Repair With Flexor Tendon Injury: Conduits are Less Effective
Journal article   Open access   Peer reviewed

Digital Nerve Repair With Flexor Tendon Injury: Conduits are Less Effective

Jonathan Isaacs, Sanju Eswaran, Asif Ilyas, Kenneth R Means and L Scott Levin
Hand (New York, N.Y.), p15589447251406917
30 Dec 2025
DOI: https://doi.org/10.1177/15589447251406917
PMID: 41472406
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12756053/View
Open

Abstract

conduits digital nerves nerve graft nerve repair processed acellular nerve allograft
Digital nerve injuries resulting in gaps not amendable to direct coaptation are frequently reconstructed utilizing conduits or processed nerve allograft (PNA). Concurrent flexor tendon repair necessitates the incorporation of a postoperative rehab protocol. The effects of this early mobilization on digital nerve regeneration following PNA or conduit reconstruction are not known.BACKGROUNDDigital nerve injuries resulting in gaps not amendable to direct coaptation are frequently reconstructed utilizing conduits or processed nerve allograft (PNA). Concurrent flexor tendon repair necessitates the incorporation of a postoperative rehab protocol. The effects of this early mobilization on digital nerve regeneration following PNA or conduit reconstruction are not known.Patient data collected during the RECON study included static 2-point discrimination (S2PD) and Semmes-Weinstein Monofilament testing following digital nerve reconstruction for gap defects of 5 to 25 mm with either PNA or conduits. Additional data included concurrent procedures such as flexor tendon repair and participation in rehab protocols. Outcomes were compared with respect to concurrent flexor tendon repair across all reconstruction techniques.METHODSPatient data collected during the RECON study included static 2-point discrimination (S2PD) and Semmes-Weinstein Monofilament testing following digital nerve reconstruction for gap defects of 5 to 25 mm with either PNA or conduits. Additional data included concurrent procedures such as flexor tendon repair and participation in rehab protocols. Outcomes were compared with respect to concurrent flexor tendon repair across all reconstruction techniques.A total of 182 enrollees were included in analysis. Of these, 67 patients suffered concomitant flexor tendon and digital nerve injuries. Thirty-five and 32 of these patients received PNA and collagen conduits for their nerve repairs, respectively. For the patients that underwent tendon repair, S2PD was 6.8 mm in the PNA group and 8.1 mm in the conduit group. S3 + or better was achieved following 65.7% of the PNA and 71.9% conduit reconstructions in the flexor tendon repair group. A significantly lower percentage of conduit repairs achieved American Society for Surgery of the Hand classification normal and fair in patients with tendon injuries (50%) versus those without tendon injury (73.3%) (P = .038).RESULTSA total of 182 enrollees were included in analysis. Of these, 67 patients suffered concomitant flexor tendon and digital nerve injuries. Thirty-five and 32 of these patients received PNA and collagen conduits for their nerve repairs, respectively. For the patients that underwent tendon repair, S2PD was 6.8 mm in the PNA group and 8.1 mm in the conduit group. S3 + or better was achieved following 65.7% of the PNA and 71.9% conduit reconstructions in the flexor tendon repair group. A significantly lower percentage of conduit repairs achieved American Society for Surgery of the Hand classification normal and fair in patients with tendon injuries (50%) versus those without tendon injury (73.3%) (P = .038).Following digital nerve gap reconstruction in a large multi-center prospective, randomized trial, concurrent flexor tendon repair with early mobilization may have compromised conduit efficacy.CONCLUSIONSFollowing digital nerve gap reconstruction in a large multi-center prospective, randomized trial, concurrent flexor tendon repair with early mobilization may have compromised conduit efficacy.NCT01809002.CLINICAL TRIAL REGISTRYNCT01809002.

Metrics

5 Record Views

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
Logo image