Reconstruction Of Median Nerve In Forearm With Type Ⅰ Collagen Nerve Conduits

Objective: To observe and evaluate patients with median nerve injury in the distal forearm treated with type I collagen nerve conduits. Methods: 8 patients with injury to the median nerve in the distal forearm underwent treatment with a type I collagen nerve conduit. The nerve gaps under 10 mm, after treatment at a minimal follow-up of 7 months and a mean follow-up of 14 months. Residual pain was evaluated using a visual analog scale. Functional outcome was quantified by assessing static 2-point discrimination(S2PD),nerve conduction velocity recorded by EMG, and Disabilities of the Arm、Shoulder and Hand(DASH)outcome measure scoring. Results: We observed no implant-related complications. Of 8 patients, 6 were free of pain. The static 2-point discrimination was less than6 mm in1 patients, between6 and 10 mm in5 patients, and over 10 mm in2 patients. 4 patients reached a status of M4 or higher, 1patient reached full muscle strength. Conclusion: Autologous nerve grafts are the current golden standard for reconstruction of peripheral nerve injuries, but they have a number of associated disadvantages, such as donor site morbidity, limited availability. Minimal tension primary anatomical end-to-end neurorrhaphy is common use in clinical for nerve repair, but they have some complications with scarring and formation of painful neuromas. This study shows biomaterial nerve conduit has good outcome to repair short peripheral nerve defects of less than 10 mm can avoid the complications such as scarring, mismatch and the disadvantages of donor site morbidity, limitedavalibility.