Allograft Beats Conduit for Longer Digital Nerve Repairs

A well-done RCT clarifies things nicely in the conduit-versus-allograft conversation for digital nerve reconstructions.

Smart Practice: Use processed (decellularized) nerve allograft rather than bovine collagen conduits for fixing longer (15-25 mm) digital nerve lacerations.

What’s the Claim?

A randomized trial compared processed (decellularized) nerve allografts to nerve conduits of bovine collagen for reconstruction of digital nerve lacerations within 24 weeks of injury, and found that allografts delivered:

  • Better 2-point discrimination for long-gap (15 to 25 mm) repairs but no important differences for short gaps (5 to 14 mm)
  • Normal sensation and protective sensation in a higher proportion of patients undergoing long-gap repairs (40% vs. 18% and 80% vs. 70%, respectively), but, again, no differences for short gaps

Complications and reoperations were poorly characterized but did not seem to differ between the treatment groups.

How’s It Stack Up?