PMC6171255_01
Macro and radiological findings. (a) Macrofinding at 2 weeks after injury. A scar around the ulnar side of the distal interphalangeal (DIP) joint and submaxillary hematoma in index finger was observed. (b) X-ray finding. No fracture was observed.
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A wound scar was observed near the distal interphalangeal (DIP) joint of the ulnar side of the index finger (Figure 1(a)). There were no radiological findings suggestive of fracture (Figure 1(b)).
Postoperative course of Semmes-Weinstein monofilament test. (a) Preoperative period. Ulnar side of the apex of the index finger had no sensation. (b) 1 month after surgery. Sensory disturbance recovered. (c) 3 months after surgery. (d) 6 months after surgery. The entire area with the exception of the injured site appeared normal.
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Ltd., Japan) (Figure 2(a)). In the Semmes-Weinstein monofilament test, the sensory disorder recovered gradually and completely recovered 6 months postoperatively (Figure 2(b)-(d)).
Results of the sensory nerve conduction study. Sensory nerve action potentials (SNAPs) were collected using the antegrade recording method by applying a stimulation to the digital nerve and deriving SNAPs from the forearm just above the median nerve with a surface electrode. (a) Preoperative period. No SNAPs were observed following stimulation at both sides of the index finger beyond the scar. (b) 3 months after surgery. SNAP was observed in each area. (c) 6 months after surgery. Sensory nerve conduction velocity increased compared with that 3 months after surgery. (d) The stimulation point.
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No derivation of SNAP was observed in the distal area of the index finger (Figure 3(a)). The derivation of SNAP was confirmed 3 months postoperatively, and it became normal 9 months postoperatively (Figures 3(b) and 3(c)).
Intraoperative findings. (a) After neurolysis, severe adhesion was observed at the scar area (arrowhead). (b) Intrafascicular injection of platelet-rich plasma (PRP) using a 25-gauge needle. (c) After PRP injection.
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After undergoing neurolysis, 0.5 ml of PRP was intraneurally injected at two locations of the injured area that was identified based on intraoperative findings (total administration volume = 1 ml) (Figure 4).
Postoperative course of visual analog scale (VAS) for pain.
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A decrease in neuropathic pain was observed immediately after surgery (Figure 5).