Optimal Treatment of Digital Nerve Injury: A Systematic Review and Bayesian Network Meta-Analysis.

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Regenerative Medicine

Background:

• Digital nerve injuries are common peripheral nerve injuries.
• Optimal techniques for sensory restoration after digital nerve repair are sought.
• Systematic review and Bayesian network meta-analysis were employed.

Purpose of the Study:

• To determine the optimal technique for sensory restoration in digital nerve repair.
• To compare neurorrhaphy, allograft, autograft, and conduit repair methods.
• To evaluate outcomes including static and moving 2-point discrimination.

Main Methods:

• Systematic review and Bayesian network meta-analysis of 13 studies.
• Analysis of static 2-point discrimination (S2PD) and moving 2-point discrimination (M2PD).
• Sensitivity analyses were conducted, excluding neurorrhaphy.

Main Results:

• Allograft demonstrated superiority for S2PD (SUCRA: 70.39).
• Neurorrhaphy ranked highest for M2PD (SUCRA: 70.71).
• Excluding neurorrhaphy, allograft also ranked highest for M2PD (SUCRA: 69.91). Conduit repair showed significantly worse outcomes for both S2PD and M2PD.

Conclusions:

• Allograft is highlighted as the most effective technique for sensory recovery in digital nerve injuries.
• Allograft is particularly beneficial when neurorrhaphy is not feasible.
• Conduit repair is less effective for sensory restoration in digital nerve injuries.