J L Martínez-Peniche, E Hernández-Méndez-Villamil, P J Haquet-Guerrero, A J Espinosa-Gutiérrez
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引用次数: 0
摘要
导言:神经损伤是一种潜在的灾难性伤害。它们会导致运动功能丧失、剧烈疼痛和神经瘤的形成。桡神经浅支在第一背室松解术中处于危险之中,其损伤可导致神经瘤的形成。自体神经重建是治疗小神经间隙的金标准。病例介绍:我们接诊了两例成年女性患者(女/47 岁,女/51 岁),她们曾在另一家医院接受过第一背室松解术。两名患者都出现了令人衰弱的神经性疼痛以及手术部位的异感。他们被诊断为桡神经浅神经瘤。他们尝试了口服药物和物理治疗,但都没有成功。于是进行了手术探查和自体神经重建。从视觉模拟量表(VAS 9-10 到 VAS 1-2)来看,两名患者的疼痛都得到了很好的缓解。结论:神经瘤是手术中未识别的神经病变引起的可怕并发症,治疗困难,需要多学科管理。这两个病例表明,自体神经重建是恢复神经组织小间隙功能的绝佳选择。
[Reconstruction of painful neuroma of superficial branch of radial nerve after first dorsal compartment release: presentation of two cases].
Introduction: nerve lesions are potentially catastrophic injuries. They can cause motor loss, severe pain and neuroma formation. The superficial branch of the radial nerve is at risk during first dorsal compartment release, its injury can cause neuroma formation. Autologous nerve reconstruction is the gold standard for treatment of small nerve gaps.
Cases presentation: we present two cases of adult women (F/47 y F/51) with a prior history of first dorsal compartment release in another institution. Both patients developed debilitating neuropathic pain, as well as allodynia in the surgical site. They were diagnosed with superficial radial nerve neuroma. Oral medication and physical therapy was attempted without success. Surgical exploration and autologous nerve reconstruction was performed. Both patients had excellent relief of pain from visual analogue scale (VAS 9-10 to VAS 1-2). Postoperatively, both patients recovered partial sensitivity to pain in the zones distal to the repair.
Conclusions: neuromas are feared complications that occur with unrecognized nerve lesions during surgery, they are difficult to treat and require multidisciplinary management. These two cases demonstrate that autologous nerve reconstruction is an excellent option for recovering function in small gaps of nerve tissue.