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Operаtive Repоrt PREOPERATIVE DIAGNOSIS: Rаdiаl digital nerve injury, right index finger POSTOPERATIVE DIAGNOSIS: Radial digital nerve injury, right index finger PROCEDURE: Primary repair оf the radial digital nerve, right index finger ANESTHESIA: General ESTIMATED BLOOD LOSS: Minimal TOURNIQUET TIME: 70 minutes COMPLICATIONS: Nоne INDICATIONS: The 32-year-old male patient sustained a right index finger laceration. The patient lacerated the right index finger and found that it had altered sensibility along the radial aspect of the right index finger. The patient presented to the office and was diagnosed with a digital nerve laceration. The risks and benefits of the operation were discussed with the patient. He now presented for operative exploration and repair. DESCRIPTION OF PROCEDURE: After informed consent was obtained, the patient was given 1 g of intravenous antibiotics. He was subsequently taken to the OR and placed in the supine position with the right arm extended. Bilateral sequential compression boots were applied, and the patient was placed under general anesthesia without difficulty. The right upper extremity was prepped and draped in the usual sterile manner. The arm was then elevated and exsanguinated, and the axillary tourniquet was inflated to 250 mm Hg. The right index finger laceration was opened and was extended both proximally and distally in a zigzag manner to facilitate wound exposure. The skin flaps were dissected with a #15 blade and held in position with interrupted 4-0 nylon sutures. The subcutaneous tissues were gently dissected, and the proximal and distal aspects of the radial digital nerve were identified. There was found to be a 100 percent transection of this nerve. At this point, the OR (operating) microscope was brought into the field, and the remaining portion of the operation was performed under the microscope. Proximal and distal nerve ends were identified and released from all adjacent soft tissue structures. The proximal and distal ends were subsequently transected to create fresh edges for suturing. A primary end-to-end epineurial repair was then performed at the radial digital nerve utilizing interrupted 9-0 nylon sutures. At the end of the repair, the nerve was found to be in an excellent approximation. Two small pieces of Gelfoam® were then placed around the nerve coaptation site. The tourniquet was deflated. Bleeding points were controlled with direct pressure and hand elevation. The skin was then closed in one layer with interrupted 5-0 Prolene suture. Antibiotic ointment was applied to the incision line. Gauze dressing, cast padding, and a dorsally based plaster splint were applied to the hand, maintaining the hand in a slightly flexed position. The patient tolerated the procedure very well. He was withdrawn from general anesthesia without complications and transported to the recovery area in good condition. The patient went home today with prescriptions for antibiotics and pain medications. He planned to follow up with us in the office the following week for initial wound evaluation. First-Listed Diagnosis: First-Listed Procedure: Add'l Procedure: