■上肢感觉神经瘤可能会非常虚弱,导致疼痛和功能障碍。神经瘤的手术治疗可以是消融或重建。这项研究的主要目的是检查前臂内手术治疗的感觉神经瘤的结果,手腕,手排除数字神经瘤。
■回顾性研究了一位多外科医生对上肢感觉神经瘤进行手术治疗的患者,单一机构数据库。神经瘤的类型,记录了损伤机制和用于治疗的手术技术。收集患者报告的结果,包括症状的缓解,疼痛评分,并发症,需要进行翻修手术。平均值和比例用于分析。
■79例患者,平均年龄42.3岁,平均随访6.7个月。感觉神经瘤的类型包括23个背侧放射状感觉,21前臂内侧皮肤,15掌侧皮肤,和14背侧尺骨感觉。单个孤立的神经瘤病例(94.9%)比多个神经瘤(5.1%)更常见。67.1%(53/79)的患者在手术后出现疼痛或超敏反应,视觉模拟量表(VAS)平均改善2.0。6.3%(5/79)需要翻修手术,82%以某种身份重返工作岗位。
■可以安全地进行神经瘤的手术切除并埋入局部周围组织中,再手术率相对较低。80%的患者症状得到完全解决或改善。
UNASSIGNED: Upper extremity sensory neuromas can be extremely debilitating leading to pain and dysfunction. Surgical management of neuromas can either be ablative or reconstructive. The primary aim of this study was to examine the outcomes of surgically treated sensory neuromas within the forearm, wrist, and hand with exclusion of digital neuromas.
UNASSIGNED: A retrospective review was conducted of patients surgically treated for an upper extremity sensory neuroma from a multi-surgeon, single institution database. The types of neuroma, mechanism of injury and the surgical technique utilized for treatment were documented. Patient reported outcomes were collected including resolution of symptoms, pain scores, complications, and need for revision surgery. Averages and proportions were used for analysis.
UNASSIGNED: 79 patients were included with mean age of 42.3 years and an average follow-up of 6.7 months. The types of sensory neuromas included 23 dorsal radial sensory, 21 medial antebrachial cutaneous, 15 palmar cutaneous, and 14 dorsal ulnar sensory. Single isolated cases of neuromas were more common (94.9%) than multiple neuromas (5.1%). 67.1% (53/79) of patients experienced pain or hypersensitivity with a mean improvement of 2.0 in the visual analog scale (VAS) following surgery. 6.3% (5/79) required revision surgery, and 82% returned to work in some capacity.
UNASSIGNED: Surgical excision of neuroma and
burial into local surrounding tissue can be safely performed with a relatively low reoperation rate. 80% of patients had full resolution or improvement in their symptoms.