背景:创伤后神经性疼痛是影响手指创伤后生活质量的主要因素,文献中的报道差异很大。这可以部分归因于确定神经性疼痛的不同方法。DouleurNeuropathique4(DN4)已被验证为评估神经性疼痛存在的可靠且非侵入性工具。本研究使用DN4问卷调查了手指截肢或手指神经修复后神经性疼痛的患病率。
方法:2011年至2018年在我们机构发现了手指截肢或指神经修复的患者。经过12个月的最小随访,简式DN4(S-DN4)用于评估神经性疼痛.
结果:共纳入120例患者:50例91指截肢,70例87指手指神经修复。在截肢组,32%的患者有疼痛,18%有神经性疼痛。在数字神经修复组中,38%的患者有疼痛,14%有神经性疼痛。其次,患者-,创伤-,和治疗特异性因素,只有创伤和手术之间的时间对手指神经修复患者的神经性疼痛的患病率有显著的负面影响。
结论:这项研究表明,手指外伤后神经损伤后,持续性疼痛和神经性疼痛很常见。发生神经性疼痛的重要预后因素之一是创伤和数字神经修复时间之间的治疗延迟。这对这些损伤的手术计划具有重要的临床意义。
BACKGROUND: Post-traumatic neuropathic pain is a major factor affecting the quality of life after finger trauma and is reported with considerable variance in the literature. This can partially be attributed to the different methods of determining neuropathic pain. The Douleur Neuropathique 4 (DN4) has been validated to be a reliable and non-invasive tool to assess the presence of neuropathic pain. This study investigated the prevalence of neuropathic pain after finger amputation or digital nerve repair using the DN4 questionnaire.
METHODS: Patients with finger amputation or digital nerve repair were identified between 2011 and 2018 at our institution. After a minimal follow-up of 12 months, the short form DN4 (S-DN4) was used to assess neuropathic pain.
RESULTS: A total of 120 patients were included: 50 patients with 91 digital amputations and 70 patients with 87 fingers with digital nerve repair. In the amputation group, 32% of the patients had pain, and 18% had neuropathic pain. In the digital nerve repair group, 38% of the patients had pain, and 14% had neuropathic pain. Secondly, of patient-, trauma-, and treatment-specific factors, only the time between trauma and surgery had a significant negative influence on the prevalence of neuropathic pain in patients with digital nerve repair.
CONCLUSIONS: This study shows that persistent pain and neuropathic pain are common after finger trauma with nerve damage. One of the significant prognostic factors in developing neuropathic pain is treatment delay between trauma and time of digital nerve repair, which is of major clinical relevance for surgical planning of these injuries.