手术治疗外伤性皮神经瘤作为踝关节镜并发症的结果：5年随访。

IF 3.3 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-07-25 DOI:10.1016/j.jisako.2025.100932

Yuxin Yan MS , Yunfeng Chu BMed , Xintao Zhang M.D , Ying Shan Ph.D , Sumeng Chen MS , Yanling Wei MS , Jingting Yan MPH , Lu Bai M.D

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The diameter of the affected nerve was measured by ultrasound.</div></div><div><h3>Results</h3><div>A total of 4 (16%) patients experienced neuroma recurrence during the 5-year follow-up. In nonrecurrence cases, sensory function improvement was observed at 3 months (<em>P</em> < 0.0001) and 2 years (<em>P</em> = 0.003). There was no further statistically significant improvement to 5 years, by which time 11 patients (52.4%) had above partial recovery of sensory function (S3+, S4). The VAS pain score was 4 (3–4) preoperatively and 2 (1–2) at 3 months (Z = −4.347, <em>P</em> < 0.0001), which continued to improve, and patients got pain relief during the 2–5 years postoperative [2–5 years, 1 (0–1)]. The mean nerve diameter decreased at 3 months [preoperative, 20 (18.5–22); 3 months, 11 (9–12); Z = −6.082, <em>P</em> < 0.0001]. 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引用次数: 0

摘要

目的：探讨外伤性神经瘤作为踝关节镜术后并发症行神经瘤切除术的远期疗效。方法：回顾性分析25例经踝关节镜手术诊断为外伤性神经瘤的患者。所有患者均行显微外科神经瘤切除和神经松解的标准手术。分别在术后3个月、1年、2年和5年进行比较。感觉功能采用英国医学研究委员会（BMRC）量表进行评估。采用视觉模拟评分法（VAS）评价疼痛缓解程度。用超声测量受累神经的直径。结果：5年随访期间，共有4例（16%）患者出现神经瘤复发。结论：显微外科手术治疗外伤性踝关节皮神经瘤是有效的。患者疼痛缓解，神经功能部分恢复。大多数感觉恢复发生在头3个月，并持续到2年。然而，在一些病例中也观察到神经瘤复发。证据级别：Ⅳ。

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Outcomes of surgically treated traumatic neuromas of cutaneous nerves as complications of ankle arthroscopy: A 5-year follow-up

Objectives

To investigate the long term result of traumatic neuromas as complications of ankle arthroscopy treated by neuroma resection.

Methods

Twenty-five patients diagnosed with traumatic neuroma as complications of ankle arthroscopy were included. The standard procedure of microsurgical neuroma resection and nerve release was performed in all patients. Outcomes comparison was evaluated at 3 months, 1 year, 2 years and 5 years postoperatively. Sensory function was assessed using the British Medical Research Council (BMRC) scale. Visual analog scale (VAS) was used to evaluate pain relief. The diameter of the affected nerve was measured by ultrasound.

Results

A total of 4 (16%) patients experienced neuroma recurrence during the 5-year follow-up. In nonrecurrence cases, sensory function improvement was observed at 3 months (P < 0.0001) and 2 years (P = 0.003). There was no further statistically significant improvement to 5 years, by which time 11 patients (52.4%) had above partial recovery of sensory function (S3+, S4). The VAS pain score was 4 (3–4) preoperatively and 2 (1–2) at 3 months (Z = −4.347, P < 0.0001), which continued to improve, and patients got pain relief during the 2–5 years postoperative [2–5 years, 1 (0–1)]. The mean nerve diameter decreased at 3 months [preoperative, 20 (18.5–22); 3 months, 11 (9–12); Z = −6.082, P < 0.0001]. We did not observe a statistically significant increase of nerve diameter during the rest of follow-up time [5 years, 10 (9–11); Z = −0.765, P = 0.451].

Conclusion

Microsurgical resection was effective for traumatic neuromas of ankle cutaneous nerves. Patients experienced pain relief and partial recovery of nerve function. Most sensory recovery occurred during the first 3 months and continued to 2 years. However, neuroma recurrence was also observed in some cases.