What is Digital Nerve Repair?
Sometimes through injury, the nerves of the body can become damaged. This is common in hand or finger injuries, because the nerves are close together and are not as protected by skin and muscle. These injuries can also occur in the feet and toes. If nerves are only bruised in an injury, they tend to heal on their own. If the nerves are severed, they will most likely be painful and will not heal. Something else can also develop called a neuroma, which is a small noncancerous growth in the nerves. In this case, nerve repair surgery is a great option for relieving pain and regaining sensation.
What causes digital nerve damage that would need repair?
Most of the time, injury is the cause of nerve damage. This specifically entails injuries like deep lacerations of the hand or fingers. These can sever the nerves, and many doctors can only stitch up the wound and hope that the nerves will be able to grow back together. In some cases, they do not heal up correctly or they are too severed to heal. This kind of injury needs to heal up before a surgery can be performed. Usually nerve repair surgery is brought up as an option after an injury is healed, but nerve pain persists. Nerves are made up of two parts, a sheath known as the epineurium, and nerve fibers. If only the epineurium is damaged, this is a bit easier to repair.
Basics of digital nerve repair
As with most hand surgery, the patient will be placed under local anesthesia. The hand will be cleansed and placed so that the doctor can easily access the damaged area. Then, a small incision is made so that the surgeon can see the area where the nerves have been severed. The surgeon then uses an operative microscope to see the nerve endings. This is technically a micro procedure. The doctor will trim the nerves to expose more healthy tissue. This gives the nerves a better chance of fusing back together.
Connection
If the nerve can be reconnected without pulling, the surgeon will use extremely small stitches with dissolvable material to connect the epineurium. If the nerves are large, they may stitch the nerve fibers together before connecting the sheath as well, which may give it a better chance of healing. If the nerves cannot be reconnected easily, the doctor may instead place a small tube called a nerve conduit that will help the nerves grow back together. They may also use a nerve graft, which is harvested from elsewhere in the patient’s body. Grafts are normally used only for larger and more essential nerves. Once the sutures have been placed and all the repairs have been done as efficiently as possible, the surgeon closes the incision site and stitches or glues it shut. Most of the time, a splint is placed on the finger.
Recovery after Digital Nerve Repair
Most patients can leave the hospital directly after the surgery. The recovery time for nerve repair is varied, as nerves take much longer to heal than skin or muscles. It usually takes about 3-4 weeks before the nerves really begin to heal. Most patients will heal at the incision site quickly, but will need to be careful not to damage the area for some time after the surgery. Many patients experience pins and needles as the nerves begin to grow back together, which can be annoying and somewhat painful. However, this is a good sign that the surgery has been successful. Most patients will also be prescribed physical therapy to help prevent stiffness or other problems. This can be mildly painful as well. Some patients may also need sensory retraining to help learn how to use their nerves again and make sure everything is working correctly.
Long Term Recovery and Effects
Unfortunately, this surgery does not work for every patient. Nerves are difficult to repair, and sometimes they just do not grow back as they were before. Most patients do experience some pain relief and regain some nerve sensitivities. Sadly, many patients will not experience full nerve regrowth or sensitivity. For larger nerves, there does seem to be a better chance of recovery and regrowth. Many patients are satisfied with their results and are able to live more full and happy lives!