Outcome of digital nerve injuries in adults

Evaluations of 67 adults with 90 complete digital nerve injuries were made more than 1 year after surgery. Moving and static two-point discrimination was determined on both lateral aspects of the injured and contralateral uninjured digits. Digits with primary repairs in mild crush or saw injuries had significantly worse two-point discrimination compared with digits that had a primary repair of a simple laceration. Furthermore, in mild crush injuries, digits with primary grafting had significantly better results than those with primary repair. Patients under 40 years of age had better two-point discrimination than those over 40. Some overlap innervation from the uninjured side was noted in two of eight digits tested, since sensation of the injured side was completely lost when the uninjured nerve of that digit was anesthetized. These results support the hypothesis that better recovery is obtained if tension is avoided at the nerve repair site in mild crush or saw injuries.