Muscle-in-Vein Conduits for the Treatment of Symptomatic Neuroma of Sensory Digital Nerves.

digital nerve reconstruction hand surgery muscle-in-vein conduit neuroma pain reduction restoration of function secondary nerve repair

Journal

Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269

Informations de publication

Date de publication:
15 Sep 2022
Historique:
received: 20 08 2022
revised: 07 09 2022
accepted: 13 09 2022
entrez: 23 9 2022
pubmed: 24 9 2022
medline: 24 9 2022
Statut: epublish

Résumé

Considering the debilitating burden of neuroma resulting in a significant loss of function and excruciating pain, the use of muscle-in-vein conduits (MVCs) for the reconstruction of painful neuroma of sensory nerves of the fingers was assessed. We retrospectively analyzed 10 patients who underwent secondary digital nerve repair by MVCs. The recovery of sensibility was evaluated by static and moving two-point discrimination (2PDs, 2PDm) and Semmes-Weinstein monofilament testing (SWM). The minimum follow-up was set 12 months after the operation. The median period between trauma and nerve repair was 13.4 weeks (IQR 53.5). After neuroma resection, defects ranged from 10-35 mm (mean 17.7 mm, SD 0.75). The successful recovery of sensibility was achieved in 90% of patients after a median follow-up of 27.0 months (IQR 31.00). The mean 2PDs and 2PDm was 8.1 mm (SD 3.52) and 5.2 mm (SD 2.27), respectively. Assessment by SWM resulted in a mean value of 3.54 (SD 0.69). Reduction in pain was achieved among all patients; eight patients reported the complete relief of neuropathic pain. There was no recurrence of neuroma in any patient. Muscle-in-vein conduits provide an effective treatment for painful neuroma of digital nerves, resulting in satisfactory restoration of sensory function and relief of pain.

Sections du résumé

BACKGROUND BACKGROUND
Considering the debilitating burden of neuroma resulting in a significant loss of function and excruciating pain, the use of muscle-in-vein conduits (MVCs) for the reconstruction of painful neuroma of sensory nerves of the fingers was assessed.
METHODS METHODS
We retrospectively analyzed 10 patients who underwent secondary digital nerve repair by MVCs. The recovery of sensibility was evaluated by static and moving two-point discrimination (2PDs, 2PDm) and Semmes-Weinstein monofilament testing (SWM). The minimum follow-up was set 12 months after the operation.
RESULTS RESULTS
The median period between trauma and nerve repair was 13.4 weeks (IQR 53.5). After neuroma resection, defects ranged from 10-35 mm (mean 17.7 mm, SD 0.75). The successful recovery of sensibility was achieved in 90% of patients after a median follow-up of 27.0 months (IQR 31.00). The mean 2PDs and 2PDm was 8.1 mm (SD 3.52) and 5.2 mm (SD 2.27), respectively. Assessment by SWM resulted in a mean value of 3.54 (SD 0.69). Reduction in pain was achieved among all patients; eight patients reported the complete relief of neuropathic pain. There was no recurrence of neuroma in any patient.
CONCLUSIONS CONCLUSIONS
Muscle-in-vein conduits provide an effective treatment for painful neuroma of digital nerves, resulting in satisfactory restoration of sensory function and relief of pain.

Identifiants

pubmed: 36143300
pii: jpm12091514
doi: 10.3390/jpm12091514
pmc: PMC9503054
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Ines Ana Ederer (IA)

Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.
Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Markus Hospital, 60431 Frankfurt, Germany.

Jonas Kolbenschlag (J)

Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.

Adrien Daigeler (A)

Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.

Theodora Wahler (T)

Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.
Department of Hand, Plastic and Aesthetic Surgery, Medius Hospital Nuertingen, 72622 Nuertingen, Germany.

Classifications MeSH