Background: Trauma to peripheral nerves is relatively
common which can be caused by blunt trauma or penetrating
injuries. An important quality of the peripheral nervous system,
as compared with the central nervous system, is its remarkable
ability to recover after an injury. To improve the outcome in
post-traumatic peripheral nerve injury beside precise suturing
and orientation of the nerve stumps is to protect the anastomosis
from the surrounding environment; this barrier should be
biologically inert, biodegradable and non-compressive. Vein
wrapping to the site of anastomosis was described to protect
the neuro-anastomosis and to improve nerve conduction and
prevent neuroma formation.
Methods: This randomized controlled study was conducted
on 60 patients presenting with either median or ulnar nerve
injuries in the forearm, they were divided into 3 groups were
group (A) The neuro-anastomosis was covered with a vein
segment passed through one segment and after the neurorrhaphy
the vein is stretched to cover the suture line, In Group < br />(B) The neuro-anastomosis was covered with a vein segment
who was circumferentially wrapped, In Group (C) the neuro
anastomosis was not covered with a vein wrap.
Results: After 12 months follow-up were: Functional
recovery of motor nerves, sensitivity and the presence of
neuroma at the site of nerve both group A and B showed a
more rapid motor and sensory recovery and a reduction of
the painful symptoms compared to the control group (C).
Conclusion: Both Vein wrapping techniques provides a
valid solution to avoid the dispersion of the nerve fibers,
adherent scars and painful neuromas formation.