Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou
{"title":"前臂及手掌丛状神经纤维瘤的显微外科治疗","authors":"Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.006","DOIUrl":null,"url":null,"abstract":"Objective \nTo explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. \n \n \nMethods \nFrom January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18) years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm. The postoperative function and feeling of the patients were evaluated by outpatient followed-up. \n \n \nResults \nThe pathological results of 6 patients all showed PN, and their incisions healed primarily. The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation. The remaining 5 patients had no recurrence during follow-up. The 2 point resolution of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS) , the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. \n \n \nConclusion \nThe application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation. \n \n \nKey words: \nForearm; Palm; Plexiform neurofibroma; Median nerve; Ulnar nerve; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"442-445"},"PeriodicalIF":0.0000,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Microsurgical treatment of the plexiform neurofibroma in the forearm and palm\",\"authors\":\"Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou\",\"doi\":\"10.3760/CMA.J.ISSN.1001-2036.2019.05.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. \\n \\n \\nMethods \\nFrom January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18) years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm. The postoperative function and feeling of the patients were evaluated by outpatient followed-up. \\n \\n \\nResults \\nThe pathological results of 6 patients all showed PN, and their incisions healed primarily. The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation. The remaining 5 patients had no recurrence during follow-up. The 2 point resolution of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS) , the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. \\n \\n \\nConclusion \\nThe application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation. \\n \\n \\nKey words: \\nForearm; Palm; Plexiform neurofibroma; Median nerve; Ulnar nerve; Microsurgical technique\",\"PeriodicalId\":60782,\"journal\":{\"name\":\"中华显微外科杂志\",\"volume\":\"42 1\",\"pages\":\"442-445\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-10-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华显微外科杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华显微外科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Microsurgical treatment of the plexiform neurofibroma in the forearm and palm
Objective
To explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm.
Methods
From January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18) years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm. The postoperative function and feeling of the patients were evaluated by outpatient followed-up.
Results
The pathological results of 6 patients all showed PN, and their incisions healed primarily. The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation. The remaining 5 patients had no recurrence during follow-up. The 2 point resolution of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS) , the results of the forearm and hand functions were excellent in 5 cases, good in 1 case.
Conclusion
The application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation.
Key words:
Forearm; Palm; Plexiform neurofibroma; Median nerve; Ulnar nerve; Microsurgical technique
期刊介绍:
Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery.
The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.