Digital Nerve Injury - a Case Control Study
Condition: Digital Nerve Injury
MeSH terms: Wounds and Injuries
Study type: Observational

Summary: 
      Case control study, investigating what hand function and sensory function do patients perform
      3-10 years following digital nerve injury and repair. The aim is to investigate if hand
      function is more limited following digital nerve injury in the thumb, index- and little
      finger, compared to less unburdened sensory surfaces in the fingers. Secondary aim is to
      investigate the long term sensory function following digital nerve injury.
    

Detailed description: 
      Eligible patients are individuals treated at the Department of Hand surgery in Stockholm,
      Sweden during 2012-2018. Inclusion criteria include diagnostic codes (ICD-10) for a digital
      nerve injury in the thumb (S64.3) or finger (S64.4) in combination with the surgical code
      (KKÅ97) Nomesco classification of surgical procedures for nerve repair (ACB29). Exclusion
      criteria are concomitant flexor tendon injury and/or skeletal injury, amputations, and severe
      soft tissue injuries. Patients residing outside the Stockholm region and children below 18
      years of age are also excluded. Initially a total number of 1330 patients have been
      identified. All medical records have been thoroughly scrutinized. After excluding concomitant
      tendon injury, a total of 606 patients remained with isolated digital nerve injury. A
      randomly selected sample of participants have been assigned to two groups: Patients with an
      injury to the digital nerve of the thumb, digit II radial side, digit V ulnar side were
      assigned to the "case" group and matched "controls" were randomly selected among patients
      with an injury to the digital nerves of either the ulnar side of digit II, either nerve of
      digit III and digit IV or the radial nerve of digit V. Cases and controls have been matched
      according to sex, year of injury and patient age.

      For the purpose of this study, a clinical evaluation to investigate hand function, sensory
      function, strength, and ability to discriminate warm and cold and sharp and dull will be
      conducted. Questionnaires are used for Patient Reported Outcome Measures (PROM): Disability
      of the Arm Shoulder, and Hand (QuickDASH), Patient questionnaire HQ8 arm and hand (HQ8), The
      Hospital Anxiety and Depression Scale (HADS), Saltin-Grimby Physical Activity Level Scale
      (SGPALS), and in addition Douleur Neuropathique en 4 Questions (DN4) for assessment of
      neuropathic pain will be performed. All outcomes will be compared between groups defined as
      case (digital injury to the thumb, radial nerve of the index finger or ulnar nerve of the
      little finger) or control (all other digital nerve injuries).
    

Intervention name(s): Surgical of the digital nerve
Intervention type(s): Procedure
Intervention description(s): All patients (cases and controls) were subject to surgical repair of digital nerve injury.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Participants with digital nerve injury were identified from a registry cohort consisting in
        1330 patients. They were all treated due to a digital nerve injury at our hospital 2012 -
        2018. A random sample of cases and controls were selected, matched for time from injury to
        evaluation, age and sex.