Comparison of Magnification in Primary Digital Nerve Repair: Literature Review, Survey of Practice Trends, and Assessment of 90 Cadaveric Repairs

Bernstein, Derek T.; Hamilton, Kristy L.; Foy, Christian A.; Petersen, Nancy J.; Netscher, David T.

doi:10.1016/j.jhsa.2013.04.010

Cited by 28 publications

(15 citation statements)

References 13 publications

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“…The surgical microscope does not necessarily offer significantly better surgical outcomes in every plastic application, 93 , 490 , 491 but it stands out with some advantages that other methods do not possess. Actually, the high and varied magnification and the excellent illumination provided by the microscope are critical and beneficial in many cases, such as the optimal alignment of nerve ends, 492 the precise reconstruction of uterine tube, 81 and fallopian tube, 493 as well as the minimally invasive excision of small structures such as ingrown toenails. 85 Besides, other features including the share of view with assistant and staff team, recording, and position of comfort can also facilitate a smooth surgical workflow.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Comprehensive review of surgical microscopes: technology development and medical applications

Fei

2021

J. Biomed. Opt.

100

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Section: Clinical Applicationsmentioning

confidence: 99%

Comprehensive review of surgical microscopes: technology development and medical applications

Fei

2021

J. Biomed. Opt.

100

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“…Assessment of sensory recovery after digital nerve transection thereby plays a major role and has thus been addressed by numerous studies in recent decades. [1][2][3][4][5][6][7][8][9][10] To date, a plethora of test instruments is available to expediently evaluate sensory recovery after transection of nerves. 11 Regrettably, all of these are associated with different drawbacks.…”

Section: Hand/peripheral Nervementioning

confidence: 99%

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

Klein

Fakin

Ducommun

et al. 2016

Plastic &Amp; Reconstructive Surgery

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BACKGROUND: As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection. METHODS: Patients who underwent epineural coaptation after digital nerve transection at the authors' institution between June of 2006 and December of 2011 were asked to participate in a follow-up examination assessing spatial resolution (two-point discrimination and grating orientation test) and cutaneous pressure threshold (Semmes-Weinstein monofilament test and pressure-specifying sensory device). Interinstrument correlations were conducted and critically elucidated. RESULTS: Eighty-one patients (26 female and 55 male patients; median age, 42 years; interquartile range, 23 years) were examined with a mean follow-up period of 3.5 ± 1.4 years. Although all tests could differentiate between the healthy and operated fingers, poor to moderate correlations were found between two-point discrimination and grating orientation test ((operated) = 0.483, p < 0.0001; (healthy) = 0.350, p < 0.0001), and between SemmesWeinstein monofilament test and Pressure-Specified Sensory Device testing ((operated) = 0.287, p = 0.01; (healthy) = 0.382, p < 0.001), indicating that they measure different properties. Altogether, the grating orientation test proved superior to two-point discrimination, whereas Pressure-Specified Sensory Device testing was superior to Semmes-Weinstein monofilament testing. CONCLUSIONS: Thoughtful use of test instruments is advisable when assessing sensibility of the hand. This study suggests including Pressure-Specified Sensory Device testing to assess cutaneous pressure threshold and the grating orientation test to assess spatial resolution in clinical, routine test batteries. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, III. Zurich, SwitzerlandBackground: As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection. Methods: Patients who underwent epineural coaptation after digital nerve transection at the authors' institution between June of 2006 and December of 2011 were asked to participate in a follow-up examination assessing spatial resolution (two-point discrimination and grating orientation test) and cutaneous pressure threshold (Semmes-Weinstein monofilament test and pressure-specifying sensory device). Interinstrument correlations were conducted and critically elucidated. Results: Eighty-one patients (26 female and 55 male patients; median age, 42 years; interquartile range, 23 yea...

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“…Use of a surgical microscope is preferred and has been shown to result in more precise repairs than neurorrhaphy in a cadaveric model. 35 If the lesion is distal enough, a sterile tourniquet may be used. For radial nerve injuries associated with humeral shaft fractures, fracture stabilization should be done first, followed by vascular repair if necessary, with nerve repair done last.…”

Section: Managementmentioning

confidence: 99%

Radial Nerve Injuries

Ljungquist

Martineau

Allan

2015

The Journal of Hand Surgery

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Comparison of Magnification in Primary Digital Nerve Repair: Literature Review, Survey of Practice Trends, and Assessment of 90 Cadaveric Repairs

Cited by 28 publications

References 13 publications

Comprehensive review of surgical microscopes: technology development and medical applications

Comprehensive review of surgical microscopes: technology development and medical applications

Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair

Radial Nerve Injuries

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