Comparisons of outcomes from repair of median nerve and ulnar nerve defect with nerve graft and tubulization: a meta-analysis

• Published in: Journal of reconstructive microsurgery Vol. 27; no. 8; p. 451
• Main Authors: Yang, Mei, Rawson, Jeremy L, Zhang, Elizabeth W, Arnold, Peter B, Lineaweaver, William, Zhang, Feng
• Format: Journal Article
• Language: English
• Published: United States 01.10.2011
• Subjects: Forearm Injuries - surgery; Humans; Median Nerve - injuries; Median Nerve - surgery; Nerve Transfer - methods; Neurosurgical Procedures - methods; Outcome Assessment (Health Care); Recovery of Function; Transplantation, Autologous; Ulnar Nerve - injuries; Ulnar Nerve - surgery
• ISSN: 1098-8947
• DOI: 10.1055/s-0031-1281526

In this study, an updated meta-analysis of all published human studies was presented to evaluate the recovery of the median and the ulnar nerves in the forearm after defect repair by nerve conduit and autologous nerve graft. Up to June of 2010, search for English language articles was conducted to collect publications on the outcome of median or ulnar nerve defect repair. A total of 33 studies and 1531 cases were included in this study. Patient information was extracted from these publications and the postoperative outcome was analyzed using meta-analysis. There was no significant difference in the postoperative recovery between the median and the ulnar nerves (odds ratio = 0.98). Sensory nerves were found to achieve a more satisfactory recovery after nerve defect repair than motor nerves (P < 0.05). Median nerve can also achieve more satisfactory recovery in both sensory and motor function than ulnar nerve (P < 0.05). There was no statistical difference between tubulization and autologous nerve graft in repairing defects less than 5 cm. Based on the results of this study, a median nerve with sensory impairment was associated with improved postoperative prognosis, while an ulnar nerve with motor nerve damage was prone to a worse prognosis. Tubulization can be a good alternative in the reconstruction of small defects.