Long-term effects of sensory reeducation following digital replantation and revascularization

Abstract

The long-term maintenance of sensory gain following sensory reeducation is still unknown for replanted digits. Ten patients with 18 replanted or revascularized digits, who had received a formal sensory reeducation program for 1.5 years postoperatively, were reevaluated with moving two-point discrimination and Semmes-Weinstein pressure threshold test after discontinuing sensory reeducation for 1 year. Another four patients with seven replanted or revascularized digits, who have never received sensory reeducation after surgery, were also followed up in the same way. After cessation of sensory reeducation, the degree of moving two-point discrimination became significantly worse in the formal sensory-reeducated group (P < 0.05) and significantly improved in the group without sensory reeducation initially (P < 0.05), whereas it showed a nonsignificant change of Semmes-Weinstein threshold both in the group with formal sensory reeducation and without sensory reeducation. Sensory retraining did influence the progressive change of moving two-point discrimination, but not in a parallel way with the Semmes-Weinstein threshold test.

Replantation of multiple fingertip amputations using super microsurgery: A case report and literature review

“…Lee et al 27 proposed the effect of the number and proportion of repaired arteries and veins on the survival rate of fingers in replantation, and indicated that there were differences in the repair of blood vessels among different regions. Shieh et al 28 maintained that performing related exercises after the replantation treatment of fingertip injuries can affect the sensory recovery of fingers. Later, with the advancement in technology, super microsurgery, tissue engineering, and other techniques emerged and developed.…”

Passive and active exercise improve regeneration and muscle reinnervation after peripheral nerve injury in the rat

“…Furthermore, activation of sensory afferents via electrical stimulation can modulate spinal reflex circuits9, 11 and ameliorate neuropathic pain 12, 13. Intensive programs of sensory re‐education after nerve injury can improve tactile discrimination and threshold perception, although this effect may wane after cessation of training 14. Combined rehabilitation of motor and sensory function by passive or active exercise programs may eventually lead to better coordination of sensory–motor tasks and restoration of adequate circuitry at the spinal level.…”

Fingertip replantation: Technical considerations and outcome analysis of 24 consecutive fingertip replantations

“…Of note, in our series none of the patients complained of cold intolerance. Shieh et al [17] also emphasized the importance of long period of sensory re-education. We also consider that postreplantation rehabilitation and re-education have an important influence on the overall sensory recovery.…”