RECONSTRUCTION OF UPPER-EXTREMITY PERIPHERAL-NERVE INJURIES WITH EPTFE CONDUITS

This reported investigation was designed to determine the role of a ne w synthetic conduit-expanded polytetrafluoroethylene (ePTFE) tube-in c linical repair of median and ulnar nerves in the upper extremities. Th e main goals of this study were: to determine the effectiveness of the ePTFE conduit in clinical nerve reconstruction; to evaluate the poten tial of this technique in reconstruction of various nerve gaps (1.5 to 6 cm); and to analyze the results of repair with the ePTFE tube regar ding different mechanisms of injury. Forty-three patients were evaluat ed. 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 reconstructions, and the average delay from injury to repair was 4.2 months. With regard to the nerve-gap lengths, patients were categorized in two groups. Group 1 (gaps from 1.5 to 4 cm) included 28 patients (17 median nerve injuries and 11 ulnar nerve injuries), and Group 2 (gaps from 4.1 to 6 cm) comprised 15 patients ( 4 median nerve injuries and 11 ulnar nerve injuries). Results showed t hat 78.6 percent of patients from Group 1 demonstrated functional moto r and sensory recovery, while reconstruction of only 13.3 percent of p eripheral nerves from Group 2 resulted in useful reinnervation. Accord ing to published results, ePTFE conduit is a reliable and successful s urgical procedure for nerve repair in reconstruction of nerve gaps up to 4 cm between the ends of median and ulnar nerves in various levels of the upper extremity. Because of its properties, ePTFE conduit has t he advantages of promoting better nerve regeneration, compared to othe r synthetic tubes, especially in reconstruction of proximal nerve inju ries, larger nerve gaps, and in cases with unfavorable mechanisms of n erve injury.