Atherton D D, Leong J C S, Anand P, Elliot D
Hand Surgery Department, St. Andrew's Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK.
J Hand Surg Eur Vol. 2007 Feb;32(1):38-44. doi: 10.1016/j.jhsb.2006.10.013. Epub 2006 Nov 28.
This paper reports the results of treatment by proximal relocation of 46 painful end-neuromas or scarred nerves in 33 patients from the pre-defined Zone II of the hand. The relocated nerves included four palmar cutaneous branches of the median nerve, 17 dorsal branches of the ulnar nerves and 25 digital nerves. If no pain at the original site and no pain or only mild pain at the relocation site are considered an adequate treatment of these difficult problems, these relocation procedures achieve complete control of spontaneous baseline pain, complete control of spontaneous spikes of pain, 93% control of direct pressure pain, complete control of movement pain (excluding the extremes of movement of the wrist into extension, supination and, less frequently, pronation) and 96% control of hypersensitivity of the overlying skin.
本文报告了对33例手部预先定义的Ⅱ区46个疼痛性终末神经瘤或瘢痕化神经进行近端移位治疗的结果。移位的神经包括4条正中神经掌皮支、17条尺神经背支和25条指神经。如果将原部位无疼痛以及移位部位无疼痛或仅有轻度疼痛视为对这些难题的充分治疗，那么这些移位手术可完全控制自发性基线疼痛、完全控制自发性疼痛发作、93%控制直接压迫性疼痛、完全控制运动性疼痛（不包括腕关节极度伸展、旋后以及较少见的旋前运动）以及96%控制覆盖皮肤的超敏反应。
