Experience of using the bioresorbable copolyester poly(DL-lactide-ε-caprolactone) nerve conduit guide Neurolac™ for nerve repair in peripheral nerve defects: Report on a series of 28 lesions

医学 神经瘤 肘部 外科 下牙槽神经 正中神经 桡神经 神经外膜修复 手腕 神经修复 前臂 周围神经 牙科 解剖 臼齿
作者
Ștefan Chiriac,Sybille Facca,M. Diaconu,S. Gouzou,P. Liverneaux
出处
期刊:Journal of Hand Surgery (European Volume) [SAGE Publishing]
卷期号:37 (4): 342-349 被引量:83
标识
DOI:10.1177/1753193411422685
摘要

Synthetic nerve guides are occasionally used to repair nerve defects. The aim of the present work was to analyse the results of Neurolac™ use in a series of 23 patients. We operated on 28 nerve lesions located on various sites: arm (n = 1), elbow (n = 5), forearm (n = 4), wrist (n = 2), palm (n = 5), fingers (n = 11). Defects averaged 11.03 mm and were repaired using Neurolac™. After an average of 21.9 months' follow up (3-45 months), subjective criteria (pain, cold intolerance, Quick DASH) and objective criteria (strength, Weber and Semmes-Weinstein sensitivity tests) were compared with the contralateral side. Average pain score was 2.17/10. Cold intolerance was reported in fifteen cases. Quick DASH averaged 35.37/100. Grip strength averaged 64.62% of the contralateral side. As regards sensitivity, the difference between the two sides was 18.89 on Weber's test, and 46.92 on Semmes-Weinstein. Defect size did not affect the outcomes. We observed eight complications the most serious being two fistulizations of the Neurolac™ device close to a joint and one neuroma. Neurolac™ presents some advantages (resorption, semi-permeability, emergency use, tenseless repair) like other synthetic guides used for nerve regeneration and its transparency constitutes an added benefit. However, some difficulty in its handling and its expensiveness represent real disadvantages. Our results are not in favour of its use in repairing hand nerve defects.
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