Surgical repair of a 30 mm long human median nerve defect in the distal forearm by implantation of a chitosan-PGA nerve guidance conduit

J Tissue Eng Regen Med. 2012 Feb;6(2):163-8. doi: 10.1002/term.407. Epub 2011 Mar 3.

Abstract

This paper describes a clinical case study in which a chitosan/polyglycolic acid nerve guidance conduit (chitosan-PGA NGC) was utilized to repair a 30 mm long median nerve defect in the right distal forearm of a 55 year-old male patient. Thirty-six months after the nerve repair, the palm abduction of the thumb and the thumb-index digital opposition recovered, facilitating the patient to accomplish fine activities, such as handling chopsticks. Static two-point discrimination measured 14, 9 and 9 mm in the thumb, index and middle fingers of the right hand. Reproducible compound muscle action potentials were recorded on the right abductor pollicis. The ninhydrin test, a classical method for assessing sympathetic nerve function, showed partial recovery of the perspiration function of the injured thumb, index and middle fingers. This repair case suggested a possible strategy for the clinical reconstruction of extended defects in human peripheral nerve trunks by the implantation of chitosan-PGA NGCs.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials / drug effects
  • Amino Acids / metabolism
  • Chitosan / pharmacology*
  • Forearm / innervation*
  • Forearm / pathology
  • Forearm / physiopathology
  • Guided Tissue Regeneration / methods*
  • Humans
  • Male
  • Median Nerve / drug effects
  • Median Nerve / pathology
  • Median Nerve / physiopathology
  • Median Nerve / surgery*
  • Middle Aged
  • Muscles / drug effects
  • Muscles / physiopathology
  • Ninhydrin / metabolism
  • Polyglycolic Acid / pharmacology*
  • Prosthesis Implantation*
  • Reconstructive Surgical Procedures / methods*
  • Recovery of Function / drug effects
  • Wound Healing / drug effects

Substances

  • Amino Acids
  • Polyglycolic Acid
  • Chitosan
  • Ninhydrin