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Implantation and Control of Wireless, Battery-free Systems for Peripheral Nerve Interfacing
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Cold Intolerance Following Digital Nerve Injury: A Multicenter Prospective Randomized Comparison of Decellularized

Asif M Ilyas1, David J Kirby1, Alexis Kasper1

  • 1Thomas Jefferson University, Philadelphia, PA, USA.

Hand (New York, N.Y.)
|November 26, 2024
PubMed
Summary

Processed nerve allograft (PNA) repairs significantly improved cold intolerance in patients compared to conduit-based (CONDUIT) repairs. PNA demonstrated better outcomes, especially for those with severe cold intolerance after digital nerve injury.

Keywords:
cold intolerancediagnosisdigital nerve gapnervenerve allograftnerve conduitnerve injury

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Area of Science:

  • Regenerative medicine
  • Neurosurgery
  • Orthopedics

Background:

  • Digital nerve injuries often lead to significant cold intolerance.
  • Understanding the evolution of cold intolerance is crucial for patient recovery.
  • Comparing nerve repair methods can reveal superior treatment options.

Purpose of the Study:

  • To compare the effectiveness of processed nerve allograft (PNA) versus conduit-based (CONDUIT) repairs in alleviating cold intolerance.
  • To investigate the impact of nerve gap size on cold intolerance outcomes.
  • To assess the long-term effects of different repair methods on sensory function.

Main Methods:

  • A multicenter trial randomized 183 patients with digital nerve gaps to PNA or CONDUIT repair.
  • Cold Intolerance Symptom Severity (CISS) scores and sensory function were assessed up to 12 months post-surgery.
  • Patients and assessors were blinded to the treatment allocation.

Main Results:

  • Both PNA and CONDUIT repairs reduced CISS scores from baseline.
  • Significantly more patients receiving PNA converted from severe to mild cold intolerance compared to CONDUIT.
  • CISS scores showed a significant correlation with sensory function testing.

Conclusions:

  • Processed nerve allograft (PNA) repairs offer superior outcomes for cold intolerance compared to CONDUIT repairs.
  • PNA is particularly effective for patients with pre-existing severe cold intolerance.
  • Nerve repair choice impacts cold intolerance resolution, independent of nerve gap size.