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Review Question - QID 3081

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QID 3081 (Type "3081" in App Search)
You are seeing a 24-year-old male in the emergency room after he was involved in a knife fight. He has severed the common digital nerve to the index finger on his dominant hand, with an 8mm gap between nerve ends. In counseling him about repair, which of the following options is as good as autologous nerve grafting?

Glycolide trimethylene carbonate conduit

5%

191/3623

Collagen conduit

59%

2133/3623

Silicone sleeve

7%

253/3623

Primary end-to-end repair

18%

652/3623

Polyglycolic acid conduit

11%

381/3623

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Repair of segmental nerve loss in the hand using collagen conduits allows for nutrient exchange and accessibility of neurotrophic factors to the axonal growth zone during regeneration. While the other listed answers have been used, none has shown the efficacy of collagen conduits or autograft.

Li et al. describe the repair of peripheral nerves with a tubular collagen conduit and review supporting data from in vitro and in vivo primate studies to this regard.

Bertleff et al. describe the recovery of sensory nerve function after treatment of traumatic peripheral nerve lesions with a biodegradable poly(DL-lactide-epsilon-caprolactone) neurolac nerve guide, compared to their control of end-to-end repair, no autologous grafting. They show equal results between primary end-to-end repair and their synthetic graft.

Waitayawinyu et al. compared 2 synthetic polyglycolic acid conduits to autogenous nerve grafting using histopathologic and neurophysiologic analyses in a segmental defect rat model. They found that collagen conduits and autografts produced comparable results, which were significantly better than polyglycolic acid conduits.

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