Schematic diagram displaying digital nerve anatomy. Grey shading denotes zone of damage for inclusion into the trial. Darkish shading denotes zone of damage within the ‘essential zones,” a minimization issue within the examine. Credit score: British Journal of Surgical procedure (2025). DOI: 10.1093/bjs/znaf174
The primary ever trial of microsurgical suture restore vs. nerve alignment for digital nerve accidents suggests suture restore doesn’t enhance outcomes.
Digital nerve accidents are the most typical kind of nerve damage handled surgically within the U.Ok., typically attributable to sharp cuts to the fingers. About 3,000 digital nerve repairs are carried out yearly throughout England and Wales with the goal of retaining the sensation within the fingers. Till now, the belief has been that delicate microsurgical restore gives sufferers one of the best probability of restoration.
The NEON (Nerve rEpair Or Not) Trial, a multicenter randomized managed trial (RCT) throughout 17 NHS hospitals, in contrast outcomes between sufferers handled with conventional microsurgical suture restore and people who had their nerve ends rigorously aligned with out stitches. Regardless of being closed early by the funder, it’s the largest examine of its type on this frequent damage.
The trial, managed by the Oxford Surgical Intervention Trials Unit (SITU) and the Oxford Medical Trials Analysis Unit (OCTRU), recruited 122 sufferers and adopted them for 12 months after surgical procedure.
The examine, now revealed within the British Journal of Surgical procedure, confirmed no important distinction in patient-reported hand perform between the 2 teams, and no variations in secondary outcomes, together with issues, high quality of life, or want for additional remedy. There was a small enchancment in a single sensory check (two-point discrimination) for repaired nerves, however this didn’t translate into higher general hand perform.
Justin Wormald, NIHR Educational Medical Lecturer and co-investigator at NDORMS stated, “The NEON trial gives one of the best proof thus far on managing digital nerve accidents. We discovered that rigorously aligning the nerve ends provides leads to equal outcomes when in comparison with microsurgical restore.
“This means we can be more evidence-based when discussing treatment options for digital nerve injuries with patients, supporting patient care and the wider health care system.”
The findings might have essential implications for affected person care and NHS sources. Avoiding microsurgical restore the place it doesn’t supply extra profit might cut back working time, unlock surgical sources, and doubtlessly decrease the chance of issues.
Extra data:
Justin C R Wormald et al, The NEON (Nerve rEpair Or Not) trial: a randomized managed trial of microsurgical restore versus nerve alignment for digital nerve damage, British Journal of Surgical procedure (2025). DOI: 10.1093/bjs/znaf174
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Trial reveals that suture restore fails to enhance digital nerve damage outcomes (2025, September 11)
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