Reconstruction of Proper Digital Nerve Defects in the Thumb Using a Pedicled Nerve Graft

Not Applicable

Completed

• Conditions: Nerve Injury

• Registration Number: NCT01528397
• Lead Sponsor: The Second Hospital of Tangshan

Brief Summary

A proper digital nerve (PDN) defect in the thumb can produce partial or complete sensory loss which can result in functional disability. This article reports the treatment of the thumb PDN defect using a pedicled nerve graft harvested from the dorsal branch of the PDN. Fourteen patients with the thumb PDN defect underwent a new surgical procedure in which the pedicled nerve graft was used to bridge nerve defect. For comparison, the investigators also collected a consecutive series of 21 patients with thumb PDN defects treated using a nonvascularized sural nerve graft. This study was designed to evaluate the efficacy of pedicled nerve grafting for PDN defects in the thumb.

Detailed Description

At final follow-up, the investigators measured the sensibility of the thumb pulps and the donor sites using the Semmes-Weinstein monofilament test and static 2-point discrimination (2PD) test. The test points were at the centers of the radial and ulnar portions of the thumb pulp and the donor sites separately. Each area was tested 3 times with a Dellon-Mackinnon discriminator. Two out of 3 correct answers were considered proof of perception before proceeding to another lower value.

Study Timeline

• Study Start: 2005-05
• Primary Completion: 2009-09
• Study Completion: 2010-05
• Status Verified: 2012-01
• Study First Submitted: 2012-01-31
• Study First Submitted QC: 2012-02-07
• Last Update Submitted: 2012-02-07
• Study First Posted: 2012-02-08
• Last Update Posted: 2012-02-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 14

Inclusion Criteria

1. thumb PDN defects between the middle of the distal phalanx and the metacarpophalangeal joint;
2. PDN defects of single or both sides;
3. PDN defects 1-4 cm in length.

Exclusion Criteria

1. injury to the course of the pedicle or the donor sites;
2. PDN defects less than 1 cm or longer than 4 cm;
3. no Doppler sound at the location of the second dorsal metacarpal artery (SDMA).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
static 2-point discrimination (2PD) test	22 months	The test points were at the centers of the radial and ulnar portions of the thumb pulp and the donor sites separately. Each area was tested 3 times with a Dellon-Mackinnon discriminator. Two out of 3 correct answers were considered proof of perception before proceeding to another lower value.