Incidence of neurapraxia in digital nerve injuries

Hand surgeons presented with a hand or finger laceration and an abnormal static two-point discrimination (> or =10 mm) must determine which patients require surgical exploration. There appears to be a paucity of data in the literature defining the incidence and nature of neurapraxia in this setting. A study was conducted in a busy urban practice to better understand this problem. To determine the incidence of intact nerves (i.e., neurapraxia) in digital nerve injury patients, the authors reviewed experience with 152 patients who presented with isolated digital nerve injuries over a 33-month period. Preoperative return of sensation and negative exploration cases were combined and referred to as the trauma-induced neurapraxia (TIN) group. There were 18 non-repair cases among the 152 isolated digital nerve injuries, giving a 12 percent incidence of TIN. Sensory recovery among the TIN patients ranged from 12 days to 6 months. In this study, the authors defined a group of patients who did not require surgical repair for isolated digital nerve injury as TIN cases. The TIN group represented 12 percent of the digital nerve trauma patients and required long follow-up for sensory recovery. This information is an important part of patient education and informed consent.