Collagen tubes for digital nerve

Retro review
12 patients
9 have outcomes data. 12-22 months

2pt: good/excellent 8/9
SW: 5 full/ dim lt touch 2 / dim prot.sens 1 / loss prot. Sens 1

BG: collagen vs PGA tubes avail.
PGA tubes have head to head comparison with primary repair and grafting. – weber 2000 randomized trial

Mat. & Methods:
2 yr period
2pd, sw, qdash
Seg loss 1-2 cm
Ci’s : infx, contam, systemic instability, primary repair possible w/o tension

Blinded evaluation
8 men 4 women. Avg 33yo
Hand dominance 50/50
4 isolated nerve injury 8 multiple trauma
2 f/u < 1yr
1had subsequent amputation
Avg fu 15 mos for remaining 9

Technique: 20 mm tubes, saline, 8-0 or 9-0, epineural
Post-op: std sensory reeducation protocol
Tt80avg. Surg time 140 avg

Discussion:

Promising results
Sensory model only (no motor nerves)
? Similar to primary nerve repair and repair with autograft?

Small size, 3 Pts lost to fu
No comparison cohort: primary repair/ repair with graft

Discussed other studies
Lohmeyer
Inada
Meek