Allograft may be an option for traumatic peripheral nerve injury repairs in children
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BOSTON — Allograft to repair traumatic peripheral nerve injuries in pediatric patients was associated with no surgical complications. Some patients had normal extremity use and return to full activities postoperatively, study data showed.
At the American Society for Surgery of the Hand Annual Meeting, Jacqueline Van Gheem, MD, presented results of a prospective, single-center observational study of 18 patients aged younger than 18 years who had 24 nerves treated with allograft reconstruction procedures between September 2011 and July 2021.
Average age of the patients was 13 years and 70% of patients were male. Average length of the nerve gaps treated was 30 mm.
“So, overall, allograft does avoid donor site morbidity that is associated with autograft, and our data suggest that allograft may be a viable option for peripheral nerve injuries in our pediatric population,” Van Gheem said.
Average follow-up was about 13.7 months. “We are still following many of these patients,” she said.
Reported mechanisms of injury were motor vehicle accidents, blast injuries and lacerations.
“Other injuries that we noted were a tendinous fracture and arterial injuries,” Van Gheem said.
“The majority of our patients were fixed within 30 days of their injuries,” she said.
Based on the Wong-Baker faces scale for pain used at patients’ latest visit, all patients rated their pain at or below level 4, according to Van Gheem.
“As far as functional outcomes, six of our patients had complete normal use of their extremity, nine had no limitations to their daily activities and four did demonstrate continued atrophy and clawing,” she said, noting the two patients with continued clawing had initially injured either their ulnar nerve or median nerve.
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Van Gheem J, et al. Paper 10. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 29-Oct. 1, 2022; Boston.
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