Effectiveness of collagen nerve conduit combined with PRP for incomplete peripheral nerve injury: a retrospective case-control study

Incomplete peripheral nerve injuries with structural pathological changes in the epineurium present treatment challenges, particularly when epineurotomy is required. This study investigates whether the combination of bovine collagen artificial nerve conduit (BCANC) and platelet-rich plasma (PRP) can mitigate the adverse effects of epineurotomy and promote more effective sensory and motor nerve recovery.A total of 222 patients (ages 16-75) with incomplete peripheral nerve injuries were enrolled. The test group underwent epineurotomy combined with BCANC and PRP implantation, while the control group received epineurotomy alone. Sensory and motor recovery were evaluated using electromyography and clinical measures at 1 and 3 months post-surgery, with analyses stratified by nerve type (Median, Ulnar, Radial). For median nerve injuries, the test group showed significant improvements across multiple electrophysiological parameters; clinically, both muscle strength (MRC scale, 3 months, p = 0.008) and sensory function (MRC scale, 1 and 3 months, p < 0.05) were significantly enhanced. For ulnar nerve injuries, significant electrophysiological improvements were observed; however, clinical muscle strength and sensory function did not significantly differ. For radial nerve injuries, part of electrophysiological parameters significantly improved in the test group, and clinical sensory function (3 months, p = 0.030) was also significantly better, while muscle strength showed no significant difference. Overall functional evaluation (Disabilities of the Arm, Shoulder and Hand score) did not significantly differ between groups for any nerve type. No severe complications were noted. BCANC with PRP following epineurotomy is safe and yields significant short-term electrophysiological improvements for median, ulnar, and radial nerve injuries. Clinically, benefits included enhanced muscle strength and sensory function for median nerves, and improved sensory function for radial nerves; ulnar nerve clinical recovery and overall DASH scores were not significantly different. These findings suggest nerve-dependent clinical benefits, and further long-term studies are warranted.