Reconstruction of a painful post-traumatic medial plantar neuroma with a bioabsorbable nerve conduit: A case report

Kim, Jaesuk; Dellon, A. Lee

doi:10.1016/s1067-2516(01)80069-7

Cited by 51 publications

(21 citation statements)

References 12 publications

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“…The concept of permitting neurobiology to improve neural regeneration is best exemplified today by peripheral nerve reconstruction through bioabsorbable conduits. The clinical results with the polyglycolic acid conduit, the Neurotube TM (Synovis Life Technologies, St. Paul, MN), have been reported for the ulnar nerve at the elbow in the monkey, 1 and for the inferior alveolar nerve, 2 the spinal accessory nerve, 3 palmar digital nerves, 4-6 plantar digital nerve, 7 facial nerve, 8 and median nerve (palm) 4 in the human (Table 1). In each of these clinical situations, the nerve to be reconstructed had a gap of less than 3 cm and in each a single nerve conduit was required.…”

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confidence: 99%

Reconstruction of the human median nerve in the forearm with the Neurotube™

2007

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Reconstruction of the median nerve in the forearm traditionally has required multiple interfascicular interposition autologous nerve grafts. Recovery of two-point discrimination, even in young adults, has been reported rarely. Two patients, aged 43 and 61, are reported with 5-year follow-up of median nerve reconstruction in the distal forearm in which multiple interposition bioabsorbable polyglycolic acid conduits (Neurotube) were used to bridge the 3-cm nerve defects. Four separate 2.3-mm diameter, 4.0-cm long conduits were used in each patient. Sensory re-education was used for rehabilitation. Each patient recovered two-point discrimination with good localization in the thumb, index, and middle finger by 2 years after the nerve reconstruction. Both patients recovered abductor pollicis brevis function.

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Reconstruction of the human median nerve in the forearm with the Neurotube™

2007

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“…Kollagen scheinen untereinander vergleichbare Ergebnisse zu liefern, wenngleich eine direkte Gegenüberstellung noch aussteht. Gute Ergebnisse wurden allgemein bis Defektstrecken von 30 mm [3,5,12,16,22,29], in Einzelfällen sogar bis 40 mm beschrieben [2,4,11]. Im europäischen Raum sind zurzeit Nervenröhrchen von bis zu 40 mm Länge und mit einem Innendurchmesser bis 10 mm zur Überbrü-ckung von Nervendefektstrecken bis maximal 30 mm zugelassen.…”

Section: Alternative Methoden Zur Rekonstruktion Peripherer Nervendefunclassified

“…sekundäre Rekonstruktionen gleichermaßen geeignet, ebenso für die Behandlung schmerzhafter Neurome [2,11,12]. Wenngleich die Kapazität der Nervenregeneration mit zunehmendem Alter abnimmt [18], konnten bei Patienten über 65 Lebensjahren ebenfalls gute Ergebnisse erzielt werden [2,3,29].…”

Section: Alternative Methoden Zur Rekonstruktion Peripherer Nervendefunclassified

“…Inzwischen sind mehrere Produkte aus verschiedenen synthetischen, vom Körper abbaubaren Materialien zum klinischen Einsatz zugelassen und deren Verwendung in unterschiedlichem Umfang publiziert [2,3,4,5,6,11,12,16,22,25,29]. Die Ergebnisse dieser Publikationen werden in dieser Arbeit zusammengefasst und unseren eigenen Erfahrungen gegenübergestellt.…”

Section: üBerbrückung Peripherer Nervendefekte Durch Den Einsatz Von unclassified

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Überbrückung peripherer Nervendefekte durch den Einsatz von Nervenröhrchen

Lohmeyer

Zimmermann

Sommer

et al. 2007

Chirurg

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“…It is nevertheless accepted that with further improvement, synthetic nerve guides provide an alternative for nerve repair [29]. In particular, use of synthetic conduits affords the major advantage that nerves once thought to be low priority for autograft (eg in the far periphery) due to their requirement of donor nerve from other regions, can be repaired without loss of sensation or function in "more important" regions of the body [30]. Likewise, conduits provide an alternative for the treatment of acquired nerve defects such as diabetic neuropathy [31].…”

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confidence: 99%

Engineering a multimodal nerve conduit for repair of injured peripheral nerve

et al. 2013

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Injury to nerve tissue in the peripheral nervous system (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss of sensation from the tissue innervated by the harvested nerve. The challenges that persist with nerve repair have resulted in development of nerve guides or conduits from non-neural biological tissues and various polymers to improve the prognosis for the repair of damaged nerves in the PNS. This study describes the design and fabrication of a multimodal controlled pore size nerve regeneration conduit using polylactic acid (PLA) and (PLA):poly(lactic-coglycolic) acid (PLGA) fibers within a neurotrophin-enriched alginate hydrogel. The nerve repair conduit design consists of two types of PLGA fibers selected specifically for promotion of axonal outgrowth and Schwann cell growth (75:25 for axons; 85:15 for Schwann cells). These aligned fibers are contained within the lumen of a knitted PLA sheath coated with electrospun PLA nanofibers to control pore size. The PLGA guidance fibers within the nerve repair conduit lumen are supported within an alginate hydrogel impregnated with neurotrophic factors (NT-3 or BDNF with LIF, SMDF and MGF-1) to provide neuroprotection, stimulation of axonal growth and Schwann cell migration. The conduit was used to promote repair of transected sciatic nerve in rats over a period of 4 weeks. Over this period, it was observed that over-grooming and self-mutilation (autotomy) of the limb implanted with the conduit was significantly reduced in rats implanted with the full-configuration conduit compared to rats implanted with conduits containing only an alginate hydrogel. This indicates return of some feeling to the limb via the fully-configured conduit. Immunohistochemical analysis of the implanted conduits removed from the rats after the four-week implantation period confirmed the presence of myelinated axons within the conduit and distal to the site of implantation, further supporting that the conduit promoted nerve repair over this period of time. This study describes the design considerations and fabrication of a novel multicomponent, multimodal bio-engineered synthetic conduit for peripheral nerve repair. AbstractInjury to nerve tissue in the Peripheral Nervous System (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss ...

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Reconstruction of a painful post-traumatic medial plantar neuroma with a bioabsorbable nerve conduit: A case report

Cited by 51 publications

References 12 publications

Reconstruction of the human median nerve in the forearm with the Neurotube™

Reconstruction of the human median nerve in the forearm with the Neurotube™

Überbrückung peripherer Nervendefekte durch den Einsatz von Nervenröhrchen

Engineering a multimodal nerve conduit for repair of injured peripheral nerve

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