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Abstract：
OBJECTIVE: Biomaterials used to restore digital nerve continuity after injury associated with a defect may influence ultimate outcomes. An evaluation of matched cohorts undergoing digital nerve gap reconstruction was conducted to compare processed nerve allograft (PNA) and conduits. Based on scientific evidence and historical controls, we hypothesized that outcomes of PNA would be better than for conduit reconstruction.
METHODS: We identified matched cohorts based on patient characteristics, medical history, mechanism of injury, and time to repair for digital nerve injuries with gaps up to 25 mm. Data were stratified into 2 gap length groups: short gaps of 14 mm or less and long gaps of 15 to 25 mm. Meaningful sensory recovery was defined as a Medical Research Council scale of S3 or greater. Comparisons of meaningful recovery were made by repair method between and across the gap length groups.
RESULTS: Eight institutions contributed matched data sets for 110 subjects with 162 injuries. Outcomes data were available in 113 PNA and 49 conduit repairs. Meaningful recovery was reported in 61% of the conduit group, compared with 88% in the PNA group. In the group with a 14-mm or less gap, conduit and PNA outcomes were 67% and 92% meaningful recovery, respectively. In the 15- to 25-mm gap length group, conduit and PNA outcomes were 45% and 85% meaningful recovery, respectively. There were no reported adverse events in either treatment group.
CONCLUSIONS: Outcomes of digital nerve reconstruction in this study using PNA were consistent and significantly better than those of conduits across all groups. As gap lengths increased, the proportion of patients in the conduit group with meaningful recovery decreased. This study supports the use of PNA for nerve gap reconstruction in digital nerve reconstructions up to 25 mm.
METHODS: Therapeutic III.
METHODS: We identified matched cohorts based on patient characteristics, medical history, mechanism of injury, and time to repair for digital nerve injuries with gaps up to 25 mm. Data were stratified into 2 gap length groups: short gaps of 14 mm or less and long gaps of 15 to 25 mm. Meaningful sensory recovery was defined as a Medical Research Council scale of S3 or greater. Comparisons of meaningful recovery were made by repair method between and across the gap length groups.
RESULTS: Eight institutions contributed matched data sets for 110 subjects with 162 injuries. Outcomes data were available in 113 PNA and 49 conduit repairs. Meaningful recovery was reported in 61% of the conduit group, compared with 88% in the PNA group. In the group with a 14-mm or less gap, conduit and PNA outcomes were 67% and 92% meaningful recovery, respectively. In the 15- to 25-mm gap length group, conduit and PNA outcomes were 45% and 85% meaningful recovery, respectively. There were no reported adverse events in either treatment group.
CONCLUSIONS: Outcomes of digital nerve reconstruction in this study using PNA were consistent and significantly better than those of conduits across all groups. As gap lengths increased, the proportion of patients in the conduit group with meaningful recovery decreased. This study supports the use of PNA for nerve gap reconstruction in digital nerve reconstructions up to 25 mm.
METHODS: Therapeutic III.
摘要：
目的：用于恢复与缺损相关的损伤后的指神经连续性的生物材料可能会影响最终结果。对进行数字神经间隙重建的匹配队列进行评估，以比较经处理的同种异体神经移植物（PNA）和导管。根据科学证据和历史控制，我们假设PNA的结果会比导管重建更好.
方法：我们根据患者特征确定了匹配的队列，病史,损伤机制,以及修复缺口达25毫米的数字神经损伤的时间。将数据分为2个间隙长度组：14毫米或更小的短间隙和15至25毫米的长间隙。有意义的感觉恢复被定义为S3或更高的医学研究委员会量表。通过间隙长度组之间和之间的修复方法对有意义的恢复进行了比较。
结果：八个机构提供了110名受试者（162例受伤）的匹配数据集。结果数据可用于113个PNA和49个导管维修。有意义的恢复在61%的导管组中报告，与之相比，PNA组为88%。在间隙小于等于14毫米的组中，导管和PNA结果分别为67%和92%有意义的恢复，分别。在15至25毫米的间隙长度组中，导管和PNA结果分别为45%和85%有意义的恢复，分别。在任一治疗组中没有报告的不良事件。
结论：本研究中使用PNA重建指神经的结果是一致的，并且明显优于所有组的导管。随着间隙长度的增加，导管组中有意义恢复的患者比例下降.这项研究支持在长达25mm的数字神经重建中使用PNA进行神经间隙重建。
方法：治疗III。
方法：我们根据患者特征确定了匹配的队列，病史,损伤机制,以及修复缺口达25毫米的数字神经损伤的时间。将数据分为2个间隙长度组：14毫米或更小的短间隙和15至25毫米的长间隙。有意义的感觉恢复被定义为S3或更高的医学研究委员会量表。通过间隙长度组之间和之间的修复方法对有意义的恢复进行了比较。
结果：八个机构提供了110名受试者（162例受伤）的匹配数据集。结果数据可用于113个PNA和49个导管维修。有意义的恢复在61%的导管组中报告，与之相比，PNA组为88%。在间隙小于等于14毫米的组中，导管和PNA结果分别为67%和92%有意义的恢复，分别。在15至25毫米的间隙长度组中，导管和PNA结果分别为45%和85%有意义的恢复，分别。在任一治疗组中没有报告的不良事件。
结论：本研究中使用PNA重建指神经的结果是一致的，并且明显优于所有组的导管。随着间隙长度的增加，导管组中有意义恢复的患者比例下降.这项研究支持在长达25mm的数字神经重建中使用PNA进行神经间隙重建。
方法：治疗III。
