Article

Outcomes following
peripheral nerve repairs have not significantly improved over the past few
decades. A new protocol using cortical reorganization techniques was developed
with the goal of improving nerve recovery in the hand.
PURPOSE : To determine if early sensory re-education using cortical reorganization techniques
improved sensory outcomes in the hand after repair of wrist-level nerve injuries.
METHODS: A retrospective study was completed of wrist-level peripheral nerve
repairs in patients who underwent a sensory re-education protocol which included
cutaneous anesthesia, tactile stimulation, and sensory and motor imagery. Data
for static 2-point discrimination, Semmes Weinstein monofilament assessments and
the shortened version of the Disabilities of the Arm, Shoulder and Hand
(QuickDASH) scores were collected. RESULTS: At four months post-repair, three of
seven of the median nerve lacerations had static 2-point discrimination of 7 mm
or less in at least one digit. Using the Semmes Weinstein monofilaments, 9 of 11
nerve repairs felt the 4.31 filament (protective) or better by eleven months with
five able to perceive the 2.83 filament (normal) in that time frame. CONCLUSIONS:
This limited retrospective study suggests that early sensory re-education using
cortical reorganization techniques may improve sensory outcomes. A larger scale
study is indicated to confirm our findings.
LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2015 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS