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Impact of Microscope Versus Loupes on Sensation Disturbances After Digital Nerve Repair: A Propensity Score-Matched
Agustin N Posso1, Audrey Mustoe1, Micaela Tobin1
1Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Background:
Digital nerve repair is a procedure performed to restore sensation in fingers. While surgical microscopes are used to achieve optimal outcomes, their cost may limit accessibility. Loupes, in contrast, offer a more affordable alternative, particularly in resource-limited settings. This study compares the risk of developing skin sensation disturbances in patients who underwent digital nerve repair using microscopes versus loupes.
Methods:
The TriNetX database was queried to identify patients who underwent digital nerve repair. Patients were classified into two cohorts: microscope and loupes groups. A propensity score matching analysis was performed, adjusted for multiple covariates. The primary outcome was paresthesia, while secondary outcomes included anesthesia, hypoesthesia, and hyperesthesia. These outcomes were assessed at 3, 6, and 12 months following surgery.
Results:
After matching, the microscope group consisted of 1208 patients, with the same number in the loupes group. At 3, 6, and 12 months following surgery, the risk of developing skin sensation disturbances was not significantly different between the two groups. At 12 months, the risk ratios (RR) for the outcomes were as follows: paresthesia (RR 1.24, p = 0.379), anesthesia (RR 1.50, p = 0.102), hypoesthesia (RR 1.71, p = 0.102), and hyperesthesia (RR 1.71, p = 0.102).
Conclusion:
The use of loupes for digital nerve repair appears to yield outcomes comparable to those achieved with a microscope in terms of sensation disturbances.
