Recovery of finger sensibility and somatosensory evoked potentials following digit-to-digit replantation in man

Abstract

Recovery of finger sensation and digital nerve function following digit-to-digit replantation was studied in 14 patients by clinical sensory evaluation and somatosensory evoked potentials (SEP) to digital nerve stimulation. The mean interval between injury and surgery was 8 +/- 3h; that between surgery and study was 25 +/- 7 months. Sensory examination revealed a mild hypersensitivity to cold. Pinprick, touch and hot sensations had nearly complete recovery, while vibration and two-point discrimination were impaired. In digital SEPs from the replanted side, the N9 component was present and normal in 8 patients (57%), whereas the N13 and N20 components had prolonged latency with normal central conduction time. Absence of the N9 component appeared to correlate with a more proximal level of injury and poor surgical outcome. The present data indicate that sensory recovery of the replanted digits was in general satisfactory but incomplete, and that over half of the patients had normal digital nerve conduction.