Améliorer l’issue des lésions nerveuses sensorielles traumatiques de la main par l’utilisation supplémentaire d’un tube nerveux de chitosane dans la réparation du nerf primaire — un essai bicentrique contrôlé randomisé

Peripheral sensory nerve injuries are a major problem of acute hand trauma surgery. Standard treatment is microsurgical end-to-end repair of these nerves whenever possible. If surgery fails, a permanent loss of sensibility and the formation of painful neuroma are consequences. The objective of this study was to evaluate whether the additional use of a chitosan nerve tube in primary nerve repair influences the sensory convalescence. A randomized controlled bicenter trial with parallel group design and double blinded assessment was conducted to show superiority of the additional use of a chitosan nerve tube compared to microsurgical nerve repair alone. 74 participants were enrolled. The ability of static 2-point-discrimanation (2PD) 6 months after surgery was the primary outcome parameter. Considerable secondary outcome parameters were filament recognition (Semmes Weinstein) testing, pain, appearance of neuroma and the Disabilities of the Arm, Shoulder and Hand (DASH)–score. In Intervention group both sensibility (expressed by 2PD) and tactile gnosis (expressed by Semmes Weinstein testing) could be increased significantly. Mean 2PD in control group at 6-month follow-up was 8 (2–20) mm and 6.3 (1–15) mm in intervention group ( P  = 0.029). 2PD correlated with DASH-score. In control group, 3 neuroma were found whereas none in intervention group. There were no implant-associated complications. Peripheral sensory nerve regeneration can be improved significantly by additional use of a chitosan nerve tube. An augmented ability of static 2-point discrimination has clinical relevancy.