Annals of plastic surgery · 2026
Optimal Treatment of Digital Nerve Injury: A Systematic Review and Bayesian Network Meta-Analysis.
СтатьяNetwork Meta-AnalysisСистематический обзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Alelyani Rakan H, Maniya Muhammad Talha, Althobaiti Mohammed, Aljuaid Abdulaziz Saud, Alfarej Zainb Mohammed, Shakoor Muteia, Almenhali Ahmed Abdullah, Alghamdi Tariq Ziyad, Althbaiti Muhanad Abduallh, Alshehri Mohammed Ali, Fadel Zahir T
Аннотация
BACKGROUND: Digital nerve injuries are the most prevalent form of peripheral nerve injuries. We aimed to conduct a systematic review and Bayesian network meta-analysis to determine the optimal technique for sensory restoration in patients undergoing digital nerve repair.
METHODS: An electronic search was conducted from inception to September 2025. Thirteen studies were included comparing neurorrhaphy, allograft, autograft, and conduit. Outcomes analyzed included static 2-point discrimination (S2PD) and moving 2-point discrimination (M2PD), presented as mean difference (MD) with 95% confidence intervals (CIs) or as surface under the cumulative ranking curve (SUCRA) scores and mean rank estimates. Sensitivity analyses were also performed by excluding neurorrhaphy. A P value <0.05 was considered statistically significant.
RESULTS: The pooled analysis demonstrated that allograft was the best technique for S2PD (SUCRA: 70.39, mean rank: 1.89), whereas neurorrhaphy ranked highest for M2PD (SUCRA: 70.71, mean rank: 1.88). Traditional meta-analysis also confirmed allograft's superiority for S2PD (MD = -1.44, 95% CI: -2.57 to -0.32; P = 0.01) and neurorrhaphy for M2PD (MD = -0.50, 95% CI: -0.87 to -0.13; P = 0.007). However, sensitivity analyses excluding neurorrhaphy demonstrated that allograft also ranked highest for M2PD (SUCRA: 69.91, mean rank: 1.60). Conduit repair was significantly worse than other techniques for both outcomes (S2PD : P = 0.002; M2PD : P = 0.004).
CONCLUSION: These findings highlight allograft as the most effective techniques for optimizing sensory recovery in digital nerve injuries, especially in cases where neurorrhaphy is not feasible.
METHODS: An electronic search was conducted from inception to September 2025. Thirteen studies were included comparing neurorrhaphy, allograft, autograft, and conduit. Outcomes analyzed included static 2-point discrimination (S2PD) and moving 2-point discrimination (M2PD), presented as mean difference (MD) with 95% confidence intervals (CIs) or as surface under the cumulative ranking curve (SUCRA) scores and mean rank estimates. Sensitivity analyses were also performed by excluding neurorrhaphy. A P value <0.05 was considered statistically significant.
RESULTS: The pooled analysis demonstrated that allograft was the best technique for S2PD (SUCRA: 70.39, mean rank: 1.89), whereas neurorrhaphy ranked highest for M2PD (SUCRA: 70.71, mean rank: 1.88). Traditional meta-analysis also confirmed allograft's superiority for S2PD (MD = -1.44, 95% CI: -2.57 to -0.32; P = 0.01) and neurorrhaphy for M2PD (MD = -0.50, 95% CI: -0.87 to -0.13; P = 0.007). However, sensitivity analyses excluding neurorrhaphy demonstrated that allograft also ranked highest for M2PD (SUCRA: 69.91, mean rank: 1.60). Conduit repair was significantly worse than other techniques for both outcomes (S2PD : P = 0.002; M2PD : P = 0.004).
CONCLUSION: These findings highlight allograft as the most effective techniques for optimizing sensory recovery in digital nerve injuries, especially in cases where neurorrhaphy is not feasible.