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Mesh epineurial splinting for late median nerve repair in older patients: A preliminary report
Author(s) -
Bertelli Jayme Augusto,
Kechele Paulo Roberto,
Ghizoni Marcos Flávio,
Fröde Tânia S.
Publication year - 2011
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20891
Subject(s) - medicine , surgery , sural nerve , median nerve , nerve repair , splint (medicine) , wrist , thumb , peripheral nerve , anatomy , orthodontics
Eleven patients over 40 years old, with median nerve lesions at the wrist, were operated on an average of 5 months after their injury. In six patients, the median nerve was repaired using a polypropylene mesh applied to secure the nerve stumps in contact, thereby allowing for direct repair with microsutures. Six patients had their median nerve repaired with sural grafts. The average gap length was 2.8 cm for the mesh repair, whereas it was 3.7 cm for the graft repair group. Eighteen months after surgery, pressure thresholds were perceived in the index and thumb pulp by all six patients with a mesh repair but in only two of five patients with a graft repair. Five in the mesh repair group recovered function in the abductor pollicis brevis muscle, versus none in the graft group. These preliminary results suggest that, in older patients, the use of a mesh to splint the coaptation site followed by direct nerve repair yields better recovery than conventional sural grafts. © 2011 Wiley‐Liss, Inc. Microsurgery 2011.