The NEON study: digital NErve, suture Or Not?
NEON is a randomised controlled trial funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA), led by Professor Abhilash Jain, and coordinated from the Surgical Intervention Trials Unit at the University of Oxford.
Digital nerve injuries are the most common nerve injury treated surgically in the UK. They cause loss of sensibility and can be associated with injuries to the flexor tendons and/or finger joint capsules. Treatment for digital nerve injuries typically involves direct end-to-end microsurgical repair of the cut nerve ends in an operating room by a specialist surgeon.
However, clinical uncertainty surrounds the efficacy of digital nerve repair. A recent systematic review highlighted the absence of randomised controlled trials and the lack of studies using patient reported outcome measures. Results of non-comparative observational studies showed that surgical repair led to sensory recovery to pre-injury levels in a minority of patients, whilst patients with injuries that were not repaired declined further surgical intervention to improve their sensibility. The BSSH identified the repair of digital nerves as a health resource topic to study, confirmed through a James Lind Alliance Priority Setting Exercise.
The NEON study seeks to answer whether microsurgical digital nerve repair is clinically effective, by comparing two surgical procedures. Eligible patients will have surgery, exploration, washout and repair of all other structures. Additionally 50% of patients will be randomised to traditional nerve repair, 50% to nerve alignment without sutures. After treatment, patients will be asked to complete questionnaires about their hand and their recovery, and to attend clinical assessments to complete sensory tests.
NEON is part of the NIHR Clinical Research Network Portfolio and the NIHR associate-PI scheme. It received research ethics committee approval in February 2020 and, despite delays with COVID-19, opened to recruitment in September.
Further details regarding the study are available at:
If you would like more information, to ask any questions or to join NEON as a study site, please contact the study team at firstname.lastname@example.org