Digital (Finger) Nerve Injury
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Conditions
- Digital (Finger) Nerve Injury
Digital nerve injuries, or nerve injuries to the finger, most commonly occur after a sharp laceration to the finger. In these scenarios, the laceration can transect the nerve, which results in loss of sensation. In each finger, there are two digital nerves that run on either side of the finger. The diagnosis of a digital nerve injury is based on physical exam and may include evaluation of fine-point or two-point discrimination. A thorough physical exam and evaluation is important in order to diagnose a digital nerve injury and any associated injury to nearby structures such as the flexor tendon or digital artery. Following a digital nerve injury, loss of sensation is typically permanent unless the nerve is repaired. After successful nerve repair, return of sensation may take many months and does not always occur. Generally, the younger and healthier the patient is, the better the prognosis is for return of nerve function and fingertip sensation following nerve repair.
Treatment
The treatment of a digital nerve injury is often surgical. The goal of a nerve repair is to re-attach the two ends of the nerve in a tension-free manner that will enable early range of motion and nerve gliding. Using either a microscope or loupe magnification, the hand surgeon will repair a digital nerve, which is often 1 to 2mm in diameter, with very fine suture. If there is a gap present between the two nerve ends, a nerve conduit or graft may be necessary in order to bridge the gap and to “reconstruct” the nerve.
After surgery, the nerve needs to heal from where it was cut to the tip of the finger. This process is slow (1mm per day) and can take months to a year to complete. Even with a successful nerve repair, sensation does not always return to normal. Hand therapy can be helpful after surgery for scar desensitization and range of motion exercises.
