Koch Horst, Haas Franz, Hubmer Martin, Rappl Thomas, Scharnagl Erwin
Division of Plastic Surgery, Department of Surgery, Karl-Franzens University Hospital, Graz, Austria.
Ann Plast Surg. 2003 Jul;51(1):45-50. doi: 10.1097/01.SAP.0000054187.72439.57.
Twenty-three patients (14 men, 9 women) with 24 painful neuromas underwent resection of neuroma and transposition of the nerve stump into an adjacent vein. The neuromas resulted from amputations (N = 7), tumor excision (N = 5), laceration injuries (N = 4), different types of wrist surgery (N = 3), vein-stripping procedures (N = 2), open fracture of the radius (N = 1), and toe harvest for thumb reconstruction (N = 1). The duration of painful symptoms averaged 66.7 weeks at the time of operation. Average follow-up was 26.5 months. In 22 patients the symptoms improved permanently. Twelve patients experienced complete and permanent relief of pain; some mild degree of pain returned in 8 patients. Two patients experienced moderate pain, and pain recurred unchanged 2 months postoperatively in 1 patient. The results presented are consistent with results of animal experiments demonstrating that typical neuroma does not develop in nerve stumps transposed into veins. Further clinical use of this approach is encouraged.
23例（14例男性，9例女性）患有24个疼痛性神经瘤的患者接受了神经瘤切除术，并将神经残端转位至邻近静脉。这些神经瘤由截肢（7例）、肿瘤切除（5例）、撕裂伤（4例）、不同类型的腕部手术（3例）、静脉剥脱术（2例）、桡骨开放性骨折（1例）以及用于拇指重建的取趾手术（1例）导致。手术时疼痛症状的持续时间平均为66.7周。平均随访时间为26.5个月。22例患者症状得到永久性改善。12例患者疼痛完全且永久性缓解；8例患者出现了某种程度的轻度疼痛复发。2例患者经历中度疼痛，1例患者术后2个月疼痛复发且程度未变。所呈现的结果与动物实验结果一致，表明转位至静脉的神经残端不会形成典型神经瘤。鼓励该方法在临床上进一步应用。
