Title: Digital Sensory Nerve Repair with Acellularized Nerve Allograft.
PNS ID: 110309-1, Published: 3/9/2011, Updated: 4/9/2011.
Author(s): Andrew Yee BS, Ida K. Fox MD.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO.
Abstract: A 58-year-old left hand dominant patient sustained a stab-like laceration to the right hand with a non-serrated paring knife. The injury occurred on the volar aspect of the hand just proximal to the long finger. The wound was initially irrigated and sutured closed. The patient present immediately to our institution with complaints of sensory loss along the long finger. Upon examination, the patient had loss of sensation at the radial aspect of the long finger. Sensation was normal along the ulnar aspect of the long finger, and in the remaining fingers and the hand. The patient underwent surgical exploration. The digital nerve branch to the radial aspect of the long finger was found to be intact but longitudinally injured. The zone of injury was identified and resected until healthy proximal and distal ends of the digital nerve were seen. A 2cm acellularized nerve allograft was used to bridge the nerve gap. Five months post-operatively, the patient had recovered 10/10 sensation at the volar, radial aspect of the long finger. This case describes the successful use of a 2cm acellularized allograft to reconstruct a digital nerve gap. Our institution uses acellularized allografts for reconstruction of gaps less than 3cm in small, noncritical sensory nerves.