Womack John W, Richardson David R, Murphy G Andrew, Richardson E Greer, Ishikawa Susan N
Univ. of Tennessee - Campbell Clinic, Orthopaedic Surgery, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
Foot Ankle Int. 2008 Jun;29(6):574-7. doi: 10.3113/FAI.2008.0574.
We examined a large cohort of patients who had interdigital neurectomy and evaluated their clinical outcomes by using a previously developed scoring system as well as a visual analog scale (VAS). In addition, we wanted to identify risk factors that may lead to poorer outcomes.
A retrospective review identified 232 patients who had neuroma excision between 1994 and 2004, after failure of conservative treatment. Each patient was contacted via mail and given a Neuroma Clinical Evaluation Score survey as well as a visual analog score. Each patient received a unique identification number, allowing the evaluation process to be single-blinded.
Of the 232 patients contacted, 120 (52%) returned their completed surveys. The average Giannini neuroma score was 53: 61 feet (51%) had good or excellent results, 12 (10%) had fair results, and 48 (40%) had poor results. The average VAS score was 2.5. The only significant (p = 0.027) difference in outcome was the location of the neuroma: second webspace had worse outcomes than third webspace neuromas on both the VAS and neuroma score.
This retrospective review identified location in the second webspace as a possible prognostic indicator of poor outcome, but the more important finding may be that outcomes of neuroma excision do not appear to be as successful at long-term followup as previously reported.
我们研究了一大群接受指间神经切除术的患者，并使用先前开发的评分系统以及视觉模拟量表（VAS）评估了他们的临床结果。此外，我们希望确定可能导致较差结果的风险因素。
一项回顾性研究确定了1994年至2004年间232例保守治疗失败后接受神经瘤切除术的患者。通过邮件联系每位患者，并给予神经瘤临床评估评分调查以及视觉模拟评分。每位患者都有一个唯一的识别号码，使评估过程为单盲。
在联系的232例患者中，120例（52%）返回了完整的调查问卷。詹尼尼神经瘤平均评分为53分：61只脚（51%）结果良好或优秀，12只脚（10%）结果中等，48只脚（40%）结果较差。VAS平均评分为2.5分。结果的唯一显著差异（p = 0.027）是神经瘤的位置：在VAS和神经瘤评分上，第二间隙神经瘤比第三间隙神经瘤的结果更差。
这项回顾性研究确定第二间隙的位置可能是预后不良的指标，但更重要的发现可能是神经瘤切除的长期随访结果似乎不如先前报道的那么成功。
