Does reconstructing superficial branch of radial nerve defect with a split homolateral graft prevent painful...

This study aimed to assess the efficiency of reconstructing the superficial branch of the radial nerve using a split homolateral graft to prevent painful neuromas.

From January 2019 to October 2022, 32 patients (32 forearms) with traumatic defects of the superficial branch of the radial nerve were treated using a split homolateral graft. The assessments included pain, two-point discrimination, and patient satisfaction. For comparison, another 35 patients (35 forearms) who did not undergo nerve repair were reviewed.

The mean age of the nerve repair group was 36 years (range, 18-52 years). The mean defect length was 42 ± 18 mm. The mean follow-up period was 28.5 ± 4.7 months. The mean age of the non-nerve repair group was 35 years (range, 19-54 years). The mean defect length was 45 ± 22 mm. The mean follow-up period was 27.7 ± 5.8 months. There were no significant differences in patient age (P > 0.05), defect length (P > 0.05), and follow-up period (P > 0.05). At the final follow-up, the pain scales at the injury site for the two groups were 0 ± 1 cm vs 5 ± 4 cm (P < 0.05) based on the 10-cm visual analog scale. Sensation on the dorsum of the thumb were 4.8 ± 1.5 mm for the injured hand, 4.2 ± 1.4 mm for the opposite hand, and 9.3 ± 1.6 for the non-nerve repair hand (P < 0.05). Sensation on the first web were 5.2 ± 1.5 mm for the injured hand, 4.7 ± 1.2 mm for the opposite hand, and 8.9 ± 2.6 mm for the non-verve repair hand, (P < 0.05). Based on the Short Assessment of Patient Satisfaction, patient satisfaction of the nerve repair group and non-nerve repair group were 22.3 ± 3.5 and 18.6 ± 4.7, respectively (P < 0.05).

Traumatic defects of the superficial branch of the radial nerve can be reconstructed using a split homolateral graft. Most sensations can be restored without causing morbidity. The surgery may reduce the incidence of painful neuroma formation.

Therapeutic study, Level IVa.