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Outcomes of Allograft Nerve Reconstruction in the Upper Extremity: A Five-Year Review
Corinne Wee MD, Leila Katabi BS, Kara McConaghy BS, Mona Ascha MD, Adrienne Lee MD, B. Todd Bafus MD, Kyle Chepla MD
Case Western Reserve University
2021-02-12
Presenter: Corinne Wee
Affidavit:
The entire abstract represents the original work of the resident and other authors involved.
Director Name: Edward Davidson MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background: Upper extremity peripheral nerve injuries represent over 5000 visits to United States emergency departments each year, leading to significant functional and financial burden. Nerve allografts allow surgeons to reconstruct large nerve gaps without donor site morbidity. The aim of this study was to evaluate the outcomes of nerve reconstruction using allograft in the upper extremity and assess which factors may influence these outcomes.
Methods: This is a retrospective review of all patients who underwent upper extremity peripheral nerve reconstruction with allograft by a group of three surgeons from 2015-2019. Statistics were performed using IBM SPSS Version 27 and included Independent T-tests and Pearson correlations.
Results: One hundred seventy-seven patients underwent allograft nerve reconstruction. Location of repair included: digits (n=27), hand (n=14), wrist (n=17), forearm (n=20) and the arm (n=14). 26% of patients reported improved motor function and 21% reported improved sensory function postoperatively. Improved motor function was associated with shorter defect length (p=0.022) and shorter time to repair, though the latter did not reach statistical significance (p=0.09). Shorter tourniquet time (p=0.06) and use of a nerve protector (p=0.07) were associated with improved sensory outcomes, but neither reached statistical significance. 21.5% of patients reported postoperative pain. Factors associated with postoperative pain included longer tourniquet time (p=0.03) and increased graft length (p=0.003).
Conclusion: Nerve allografts are a valuable addition to peripheral nerve repair techniques. Continued study is needed to elucidate the full impact of different patient and surgical factors on outcomes.
