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A new trial, funded by a £1.2 million National Institute of Health Research grant, will explore whether surgery is the best treatment for digital nerve injury.

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The NEON study will examine the effects of surgery following digital nerve injury – damage to the small nerves which pass along the side of each finger and provide important sensation to the fingertips. The commonest nerve injury, treatment involves specialist referral and direct end to end microsurgical repair of the cut nerve ends. However, there is limited evidence, with regards to patient reported outcome measures or functional improvement, that surgical repair offers significant benefit to patients.

Abhilash Jain, Associate Professor of Plastic and Hand Surgery, at the Botnar Research Centre, NDORMS says: “Previous studies provide conflicting results and it remains unclear whether repair is the best treatment, or even needed. Our study will compare the surgical repair of the cut nerve with sutures with a surgical procedure without the use of sutures (a simple washout of the wound) and assess fingertip sensation, quality of life and the ability of the patient to return to work.”

478 adult patients with digital nerve injuries will be included in the study which will also assess neurosensory and functional recovery in both patient groups, compare complications of surgery and clinically problematic neuroma rates; and provide a basic comparison of cost effectiveness between the suture and non-suture groups.

Funding for the NEON study was granted to the the Surgical Intervention Trials Unit (SITU)  and the trial is supported by the specialist surgical societies in the UK such as the British Association of Plastic Surgery, the British Society for Surgery of the Hand and the Reconstructive Surgery Trials Network.

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