Clinical application of inside-out vein grafts for the treatment of sensory nerve segmental defect
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Woo Joo Jeon1, Jong Woo Kang, Jung Ho Park
1Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
Purpose:
The gold standard for the treatment of segmental nerve defect is an autogenous nerve graft. However, donor site morbidity is an inevitable complication. We substituted an autogenous nerve graft with an inside-out vein graft for the treatment of segmental sensory nerve defect and the clinical results were evaluated retrospectively.
Patients And Methods:
Eleven patients of sensory nerve defects have undertaken inside-out vein grafts for the recovery of sensation. The involved nerves were digital nerves in three cases, peroneal nerves in two cases, saphenous nerve in two cases, and superficial radial nerves in four cases. The average length of defects was 2.71 cm (1-6 cm). Donor veins were harvested 4 mm longer than nerve defects and everted to promote nerve regeneration. Patients' objective satisfactions and two-point discriminations were determined, the Semmes-Weinstein monofilament test was performed, and British Medical Council sensory functional scores were evaluated.
Results:
Sensory functional scores recovered to over S3 in all cases. No donor site morbidity was caused by vein harvesting, and all patients achieved satisfactory results with protective sensation at involved sites.
Conclusion:
The inside-out vein graft offers a good surgical alternative to an autogenous nerve graft for the reconstruction of sensory nerve defects without donor site morbidity.
