Assessment of functional outcome after nerve repair in a longitudinal cohort

To investigate the temporal changes in the results of clinical tests of the functional outcome after nerve repair, we followed up 19 patients periodic ally over a four year period after repair of the median or ulnar nerve at t he forearm. Between the first and last follow-up four of the instruments us ed-Semmes-Weinstein monofilaments, manual muscle testing, Sollerman grip te st, and Jamar dynamometer-indicated significant and moderate to large impro vements. A moderate and significant improvement was also noted during the s ame period in patients' estimation of pain or discomfort. Results of the tw o-point discrimination test did not change significantly over time. Most ch anges occurred during the first postoperative year, and thereafter it was p rincipally motor function that improved. We conclude that four of the six u sed tests showed useful temporal dynamics during the follow-up time. The la ck of responsiveness in two-point discrimination test suggests that other o r complementary test instruments should be used for assessment of tactile g nosis after nerve repair.