Several nerve conduits have become available for repairing peripheral nerve defects. However, nerve regeneration using these nerve conduits is less efficacious than using autografts. At our facility, we cover the nerve conduit with a well-vascularized adipose flap, which effectively blocks scarring and prevents adhesion-related damage. Herein, we reviewed the outcomes of 12 patients with peripheral nerve injury in upper extremities, treated with nerve conduit wrapping with pedicled perforator adipose flaps. The average follow-up was 18 months. The nerve conduits were wrapped with digital artery perforator adipose flaps in six digital nerves, radial artery or digital artery perforator adipose flaps in four radial nerve sensory branches, and ulnar artery perforator adipose flaps in two ulnar nerve sensory branches. The average size of the perforator adipose flap was 308 mm2, which was enough to cover the nerve conduit. The VAS score of neuropathic pain was improved from a preoperative mean of 70 to a postoperative mean of 17. The mean scores of Quick DASH and Hand20 were 9.3 and 12 at the last follow up, respectively. Our findings suggest that nerve conduit wrapping with pedicled perforator adipose flap is an effective method for repairing peripheral nerve defects in the upper extremity.
