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截肢和神经缝合患者的症状性神经瘤发病率。

The incidence of symptomatic neuroma in amputation and neurorrhaphy patients.

机构信息

Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

出版信息

J Plast Reconstr Aesthet Surg. 2013 Oct;66(10):1330-4. doi: 10.1016/j.bjps.2013.06.019. Epub 2013 Jul 8.

Abstract

PURPOSE

The incidence of symptomatic neuroma in finger nerve injuries varies widely in the literature. In this retrospective study, we evaluated the incidence of symptomatic neuroma after repair of digital nerve injuries (neurorrhaphy) and after amputation of one or more fingers. We also determined the need for re-operation on symptomatic neuroma patients.

METHODS

In a retrospective study, we collected data from medical files. All patients who were treated for a hand trauma in the emergency department during the last 10 years were included. We gathered data on the presence of symptomatic neuroma and re-operation of the patients.

RESULTS

In our database, 583 people had a peripheral nerve injury of whom 177 people had an amputation. The incidence of digital nerve injury without amputation followed by neurorrhaphy was 1%. In digital nerve injuries with amputation the incidence was 7.8%, which is significantly higher than after digital nerve injuries without amputation.

CONCLUSIONS

People with an amputation injury have significantly more symptomatic neuroma than people who undergo neurorrhaphy. People who have a symptomatic neuroma after digital nerve injuries have been operated significantly more than people who have a non-symptomatic neuroma or no neuroma at all. This information can be of help when treating digital nerve injuries. TYPE OF STUDY/LEVEL OF EVIDENCE (LOE): Prognostic.

摘要

目的

手指神经损伤后出现症状性神经瘤的发生率在文献中差异很大。在这项回顾性研究中,我们评估了修复手指神经损伤(神经吻合术)和切除一个或多个手指后症状性神经瘤的发生率。我们还确定了需要对症状性神经瘤患者进行再次手术的情况。

方法

在一项回顾性研究中,我们从病历中收集数据。所有在过去 10 年中因手部创伤在急诊室接受治疗的患者均被纳入研究。我们收集了患者存在症状性神经瘤和再次手术的相关数据。

结果

在我们的数据库中,有 583 人患有周围神经损伤,其中 177 人进行了截肢。无截肢的手指神经损伤后行神经吻合术的发生率为 1%。而在有截肢的手指神经损伤中,其发生率为 7.8%,明显高于无截肢的手指神经损伤。

结论

截肢损伤的患者出现症状性神经瘤的比例明显高于行神经吻合术的患者。有症状性神经瘤的患者比无症状性神经瘤或根本没有神经瘤的患者接受手术的比例明显更高。这些信息在手部神经损伤的治疗中可能会有所帮助。研究类型/证据水平(LOE):预后。

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