Study Finds Suture Repair Does Not Enhance Outcomes in Digital Nerve Injuries

A recent multicenter randomized controlled trial called the NEON (Nerve Repair Or Not) study has challenged the long-held assumption that microsurgical suture repair improves recovery in digital nerve injuries. Conducted across 17 NHS hospitals with 122 participants, the study aimed to compare the effectiveness of traditional microsurgical nerve repair with careful nerve alignment without stitches. Follow-up over 12 months revealed that there was no significant difference in hand function, sensory recovery, or complication rates between the two approaches. Although a minor improvement was observed in two-point discrimination tests for the sutured nerves, it did not translate into overall better hand functionality.

Digital nerve injuries, often caused by sharp finger cuts, are among the most common nerve injuries requiring surgical intervention in the UK, with approximately 3,000 repairs annually. It has generally been presumed that delicate microsurgical repair yields the best outcomes for sensory restoration. However, the NEON trial challenges this belief, suggesting that simpler nerve alignment may be equally effective.

Justin Wormald, a lead researcher and NIHR Clinical Lecturer, stated that the trial provides the strongest evidence to date, indicating that precise alignment without suturing can produce results comparable to traditional microsurgical repair. This could influence treatment discussions and decision-making, enabling more evidence-based practices.

Importantly, avoiding microsurgical repair when unnecessary may help optimize resource use within the NHS by reducing operating times and minimizing the risk of surgical complications. The results highlight the need for re-evaluating current surgical approaches for digital nerve injuries and support more streamlined treatment options.

The full findings are published in the British Journal of Surgery (2025), emphasizing the importance of evidence-based surgery and potentially transforming standard care for digital nerve injuries.

Source: https://medicalxpress.com/news/2025-09-trial-suture-digital-nerve-injury.html