Summary
The current problem finding reliable and objective methods for evaluating results
after peripheral nerve repair is a challenge when introducing new clinical techniques.
The aim of this study was to obtain reference material and to evaluate the applicability
of different tests used for clinical assessment after peripheral nerve injuries. Fifteen
patients with a history of complete median nerve transsection and repair, and 15 healthy
volunteers were included. Each subject was investigated using a battery of conventional
and new tests for functional, sensory and motor recovery including questionnaires,
clinical evaluations, neurophysiological and physiological findings. The results were
statistically analysed and comparisons were made within the patient group and between
patients and healthy volunteers using a ‘per protocol’ and an ‘intention to treat’
approach. Criteria for success were stipulated in order to be able to judge the usefulness
of each method. The results showed that 19 of 34 variables, representing six of 16
methods, were not able to fulfil the criteria and were thus questionable for the evaluations
of nerve repair in a clinical trial setting. However, 2pd, sensory recovery according
to the non-modified British Medical Research Council, sensory neurography, manual
muscle test, electromyography, questionnaires (i.e. DASH and the 4 question form)
and performance tests (i.e. AMPS and Sollerman's subtests 4 and 8) did fulfil the
criteria defined for being useful.
Keywords
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Article info
Publication history
Published online: July 28, 2006
Accepted:
April 19,
2006
Received:
February 2,
2006
Footnotes
☆Parts of this work have been presented at the British Society for Surgery of the Hand, Autumn Meeting, 5th November 2004, Svenska Läkarsällskapets Riksstämma, Handkirurgi 25th November 2004 and the American Society for Peripheral Nerve Annual Meeting 16th January 2005.
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
