Outcomes of Surgical Treatment of Peripheral Neuromas of the Hand and Forearm.

IF 1.1 Q4 CLINICAL NEUROLOGY
Yousif Tarek El-Gammal, Laura Cardenas-Mateus, Tsu Min Tsai
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引用次数: 2

Abstract

The choice of a specific technique for surgical treatment of neuromas remains a problem. The purpose of this study is to determine the overall effectiveness of surgery as well as to find out whether certain surgical procedures are more effective than others. Twenty-nine patients operated between 1998 and 2018 and followed for at least 12 months were reviewed. Clinical assessment included the identification of a pre- and postoperative Tinel sign, pain visual analog score, two-point discrimination (2PD), and grip strength. Mechanisms of injury included clean lacerations (11), crush injuries (11), and other trauma or surgery (7). Mean time from presentation to surgery was 9 months. Seven surgical procedures involving excision in 10 patients and excision and nerve repair in 19 patients were performed. Pain score improved from an average of 7.1 ± 2.3 to 1.8 ± 1.7 with 27 patients (93%) reporting mild or no postoperative pain. Nine patients complained of residual scar hypersensitivity and six patients had residual positive Tinel. No patient required an additional surgical procedure. 2PD improved from an average of 9.6 ± 4.0 to 6.8 ± 1.0. The improvement of pain score and 2PD was statistically significant. Nerve repair resulted in marginally better outcomes, in terms of 2PD and grip strength recovery, than excision alone. The mechanism of injury, zone of involvement, time to intervention, or length of follow-up did not have an impact on the outcomes. Although patient numbers in this study are large in comparison to previous studies, larger patient numbers will allow for a multivariate analysis, which can be possible with a prospective multicenter trial.

手部及前臂周围神经瘤的手术治疗效果。
神经瘤手术治疗的具体技术选择仍然是一个问题。本研究的目的是确定手术的总体有效性,以及找出某些手术方法是否比其他手术方法更有效。对1998年至2018年期间接受手术并随访至少12个月的29例患者进行了回顾。临床评估包括识别术前和术后的Tinel体征、疼痛视觉模拟评分、两点辨别(2PD)和握力。损伤机制包括干净撕裂伤(11例)、挤压伤(11例)和其他创伤或手术(7例)。从出现到手术的平均时间为9个月。7例手术包括10例切除和19例切除和神经修复。疼痛评分从平均7.1±2.3分改善到1.8±1.7分,27例患者(93%)报告术后轻度或无疼痛。9例患者抱怨残留疤痕超敏反应,6例患者残留tiel阳性。没有患者需要额外的外科手术。2PD由平均9.6±4.0分提高到6.8±1.0分。疼痛评分和2PD改善有统计学意义。就2PD和握力恢复而言,神经修复的结果略好于单纯切除。损伤机制、受累区域、干预时间或随访时间对结果没有影响。虽然与以前的研究相比,本研究的患者人数较多,但更大的患者人数将允许进行多变量分析,这可以通过前瞻性多中心试验实现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
14.30%
发文量
6
审稿时长
12 weeks
期刊介绍: JBPPNI is an open access, peer-reviewed online journal that will encompass all aspects of basic and clinical research findings, in the area of brachial plexus and peripheral nerve injury. Injury in this context refers to congenital, inflammatory, traumatic, degenerative and neoplastic processes, including neurofibromatosis. Papers on diagnostic and imaging aspects of the peripheral nervous system are welcomed as well. The peripheral nervous system is unique in its complexity and scope of influence. There are areas of interest in the anatomy, physiology, metabolism, phylogeny, and limb growth tropism of peripheral nerves.
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