PDF(Pubmed)
Abstract：
BACKGROUND: Surgical treatment of finger nerve injury is common for hand trauma. However, there are various surgical options with different functional outcomes. The aims of this study are to compare the outcomes of various finger nerve surgeries and to identify factors associated with the postsurgical outcomes via a systematic review and meta-analysis.
METHODS: The literature related to digital nerve repairs were retrieved comprehensively by searching the online databases of PubMed from January 1, 1965, to August 31, 2021. Data extraction, assessment of bias risk and the quality evaluation were then performed. Meta-analysis was performed using the postoperative static 2-point discrimination (S2PD) value, moving 2-point discrimination (M2PD) value, and Semmes-Weinstein monofilament testing (SWMF) good rate, modified Highet classification of nerve recovery good rate. Statistical analysis was performed using the R (V.3.6.3) software. The random effects model was used for the analysis. A systematic review was also performed on the other influencing factors especially the type of injury and postoperative complications of digital nerve repair.
RESULTS: Sixty-six studies with 2446 cases were included in this study. The polyglycolic acid conduit group has the best S2PD value (6.71 mm), while the neurorrhaphy group has the best M2PD value (4.91 mm). End-to-side coaptation has the highest modified Highet\'s scoring (98%), and autologous nerve graft has the highest SWMF (91%). Age, the size of the gap, and the type of injury were factors that may affect recovery. The type of injury has an impact on the postoperative outcome of neurorrhaphy. Complications reported in the studies were mainly neuroma, cold sensitivity, paresthesia, postoperative infection, and pain.
CONCLUSIONS: Our study demonstrated that the results of surgical treatment of digital nerve injury are generally satisfactory; however, no nerve repair method has absolute advantages. When choosing a surgical approach to repair finger nerve injury, we must comprehensively consider various factors, especially the gap size of the nerve defect, and postoperative complications. Type of study/level of evidence Therapeutic IV.
METHODS: The literature related to digital nerve repairs were retrieved comprehensively by searching the online databases of PubMed from January 1, 1965, to August 31, 2021. Data extraction, assessment of bias risk and the quality evaluation were then performed. Meta-analysis was performed using the postoperative static 2-point discrimination (S2PD) value, moving 2-point discrimination (M2PD) value, and Semmes-Weinstein monofilament testing (SWMF) good rate, modified Highet classification of nerve recovery good rate. Statistical analysis was performed using the R (V.3.6.3) software. The random effects model was used for the analysis. A systematic review was also performed on the other influencing factors especially the type of injury and postoperative complications of digital nerve repair.
RESULTS: Sixty-six studies with 2446 cases were included in this study. The polyglycolic acid conduit group has the best S2PD value (6.71 mm), while the neurorrhaphy group has the best M2PD value (4.91 mm). End-to-side coaptation has the highest modified Highet\'s scoring (98%), and autologous nerve graft has the highest SWMF (91%). Age, the size of the gap, and the type of injury were factors that may affect recovery. The type of injury has an impact on the postoperative outcome of neurorrhaphy. Complications reported in the studies were mainly neuroma, cold sensitivity, paresthesia, postoperative infection, and pain.
CONCLUSIONS: Our study demonstrated that the results of surgical treatment of digital nerve injury are generally satisfactory; however, no nerve repair method has absolute advantages. When choosing a surgical approach to repair finger nerve injury, we must comprehensively consider various factors, especially the gap size of the nerve defect, and postoperative complications. Type of study/level of evidence Therapeutic IV.
摘要：
背景：指神经损伤的手术治疗在手外伤中很常见。然而,有不同的手术选择具有不同的功能结局.这项研究的目的是比较各种手指神经手术的结果，并通过系统评价和荟萃分析确定与手术后结果相关的因素。
方法：通过搜索1965年1月1日至2021年8月31日的PubMed在线数据库，全面检索了与数字神经修复有关的文献。数据提取,然后进行偏倚风险评估和质量评估.采用术后静态2点判别(S2PD)值进行Meta分析,移动两点判别(M2PD)值,和Semmes-Weinstein单丝测试(SWMF)良好率，改良Highet分类神经恢复良好率。使用R(V.3.6.3)软件进行统计学分析。采用随机效应模型进行分析。还对其他影响因素进行了系统评价，尤其是指神经修复的损伤类型和术后并发症。
结果：本研究纳入了66项研究，共2446例。聚乙醇酸导管组具有最好的S2PD值(6.71mm),而神经吻合组M2PD值最好(4.91mm)。端到端接合的Highet得分最高(98%)，而自体神经移植物的SWMF最高(91%)。年龄,间隙的大小，损伤类型是可能影响恢复的因素。损伤类型对神经吻合术后结局有影响。研究报告的并发症主要是神经瘤，冷灵敏度,感觉异常,术后感染,和痛苦。
结论：我们的研究表明，数字神经损伤的手术治疗结果总体上令人满意；然而，无神经修复方法具有绝对的优势。选择修复指神经损伤的手术方法时，我们必须综合考虑各种因素，尤其是神经缺损的间隙大小,术后并发症。研究类型/证据水平治疗IV.
方法：通过搜索1965年1月1日至2021年8月31日的PubMed在线数据库，全面检索了与数字神经修复有关的文献。数据提取,然后进行偏倚风险评估和质量评估.采用术后静态2点判别(S2PD)值进行Meta分析,移动两点判别(M2PD)值,和Semmes-Weinstein单丝测试(SWMF)良好率，改良Highet分类神经恢复良好率。使用R(V.3.6.3)软件进行统计学分析。采用随机效应模型进行分析。还对其他影响因素进行了系统评价，尤其是指神经修复的损伤类型和术后并发症。
结果：本研究纳入了66项研究，共2446例。聚乙醇酸导管组具有最好的S2PD值(6.71mm),而神经吻合组M2PD值最好(4.91mm)。端到端接合的Highet得分最高(98%)，而自体神经移植物的SWMF最高(91%)。年龄,间隙的大小，损伤类型是可能影响恢复的因素。损伤类型对神经吻合术后结局有影响。研究报告的并发症主要是神经瘤，冷灵敏度,感觉异常,术后感染,和痛苦。
结论：我们的研究表明，数字神经损伤的手术治疗结果总体上令人满意；然而，无神经修复方法具有绝对的优势。选择修复指神经损伤的手术方法时，我们必须综合考虑各种因素，尤其是神经缺损的间隙大小,术后并发症。研究类型/证据水平治疗IV.
