engleski

Reconstruction of upper-extremity peripheral-nerve injuries with EPTFE conduits

This reported investigation was designed to determine the role of a new syntetic conduit-expanded polytetrafluorethylene (ePTFE) tube- in clinical repair of median and ulnar nerves in the upper extremities. The main goals of this study were:to determine the efectiveness of the ePTFE conduit in clinical nerve reconstruction; to evaluate the potential of this technique in reconstruction of various nerve gaps (1,5 to 6 cm); and to analyze the results of repair with ePTFE regarding different mechanisms of injury. Forty-three patients were evaluated. They had upper-extremity peripheral-nerve injuries (21 injuries to the median nerve, and 22 ulnar nerve injuries) located at the various levels of the upper extremities. All surgical procedures described in the study were secondary reconstrctions, and the average delay from the injury to repair was 4,2 months. With regard to nerve-gap lenghts, patients were categorized in two groups. Group I (gaps 1,5 to 4 cm) included 28 patients (17 median nerve injuries and 11 ulnar nerve injuries), and Group 2 (gaps from 4 to 6 cm) comprised 15 patients (4 median nerve injuries, and 11 ulnar nerve injuries). Result showed that 78.6 percent of patients from Group I demonstrated functional motor and sensory recovery, while reconstruction of only 13.3 percent of peripheral nerves from Group 2 resulted in useful reinnervation. According to published results, ePTFE conduit is a reliable and successful surgical procedure for nerve repair in reconstruction of nerve gaps up to 4 cm between the neds of median and ulnar nerves in various levels of the upper extremity. Because of its properties, e PTFE conduit has the advantages of promoting better nerve regeneration, compared to other syntetic tubes, especially in reconstruction of proximal nerve injuries, larger nerve gaps, and in cases with unfavorable mechanisms of nerve injury.

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