J Reconstr Microsurg 2006; 22(3): 149-152
DOI: 10.1055/s-2006-939959
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Secondary Digital Nerve Repair in the Foot with Resorbable p(DLLA-ε-CL) Nerve Conduits

Marcel F. Meek1 , Jean-Philippe A. Nicolai1 , Peter H. Robinson1
  • 1Department of Plastic Surgery, University Medical Center Groningen, Groningen, The Netherlands
Further Information

Publication History

Accepted: December 1, 2005

Publication Date:
06 July 2006 (online)

ABSTRACT

Nerve guides are increasingly being used in peripheral nerve repair. In the last decade, much preclinical research has been undertaken into a resorbable nerve guide composed of p(DLLA-ε-CL). This report describes the results of secondary digital nerve reconstruction in the foot in a patient with post-traumatic neuromas of the common plantar digital nerves II-III and III-IV. The neuromas were resected and reconstruction of the nerves was carried out with resorbable Neurolac® nerve guides. The Pressure Specified Sensory Device™ was used to measure the static (s) and moving (m) 1- and 2-point discrimination (PD).

Fourteen months after nerve repair, the m1-PD returned in all digital nerves. The s1-PD returned only on the lateral side of the second toe. The m2-PD and s2-PD did not return in any of the toes originally innervated by the reconstructed nerves. According to the British Classification System, the sensory nerve recovery was poor. However, there were no complaints of painful neuromas after this procedure.

In conclusion, this report shows no beneficial effects of Neurolac® nerve guides in terms of return of sensibility after repair of common plantar digital nerves. Painful neuromas, however, could be well-treated.

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Marcel M MeekM.D. Ph.D. 

Department of Plastic Surgery, University Medical Center Groningen

Hanzeplein 1, 9700 RB Groningen, The Netherlands