Lateral Antebrachial Cutaneous Nerve as a Donor Source for Digital Nerve Grafting: A Concept Revisited.
- Bu çalışma, dijital sinir defektlerinin onarımında lateral antebrachial kutanöz sinirin (LACN) otogreft olarak kullanımının duyusal iyileşme üzerindeki etkinliğini değerlendirmektedir.
- Klinik sonuçlar, hastaların normal ile azalmış hafif dokunma seviyeleri arasında başarılı bir duyusal geri kazanım elde ettiğini göstermiştir.
- Defekt uzunluğu duyusal sonuçlarla anlamlı bir korelasyon gösterirken, LACN'nin donör bölgesinde minimum kayıpla güvenilir bir greft seçeneği olduğu kanıtlanmıştır.
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Digital Nerve Reconstruction with LACN Autografts: An Overview
This clinical study evaluates the effectiveness of the lateral antebrachial cutaneous nerve (LACN) as an autograft source for the repair of segmented digital nerve injuries. The research specifically focuses on both acute and delayed repair scenarios to determine the clinical availability and sensory outcomes of using LACN in reconstructive hand surgery.
Patients and Methodology
The study cohort consisted of 11 patients presenting with a total of 13 digital nerve defects. All patients underwent reconstructive surgery using interposition LACN grafts harvested from the ipsilateral extremity. To ensure comprehensive data, the following parameters were meticulously tracked:
- Mean Follow-up Period: 35.7 months.
- Mean Time to Grafting: 53.3 days post-injury.
- Assessment Tools: Static Two-Point Discrimination Test (2PDT) and Semmes-Weinstein Monofilament Test (SWMT).
- Statistical Analysis: Results were evaluated using the Paired T-test and Pearson correlation analysis to compare injured versus uninjured fingers.
Clinical Results and Statistical Findings
The clinical outcomes indicate successful sensory recovery across the patient group. The mean 2PDT value was recorded at 5.923 mm, while the mean SWMT value reached 3.52. These figures represent a sensory level ranging between normal and diminished light touch.
Key Statistical Correlations
| Parameter | Finding |
|---|---|
| Mean Graft Length | 18.5 mm |
| Defect Length vs. SWMT | Positive and significant statistical correlation |
| Patient Age vs. Recovery | No statistically significant correlation |
| Sensory Outcome | Range between normal and diminished light touch |
Statistical analysis revealed that the defect length is significantly correlated with the difference in SWMT values. However, factors such as the age of the patient did not show a statistically significant correlation with the final 2PDT or SWMT outcomes.
Conclusion: LACN as a Viable Graft Option
Based on the observed sensory regaining at the recipient site and the negligible sensory deficit at the harvesting (donor) site, the study concludes that the lateral antebrachial cutaneous nerve is a highly valuable graft option. It serves as an effective solution for addressing digital nerve defects, providing reliable functional recovery with minimal donor-site morbidity.
