Milone Michael T, Klifto Christopher S, Catalano Louis W
Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY.
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC.
J Hand Surg Am. 2018 Mar;43(3):272-277. doi: 10.1016/j.jhsa.2017.12.012.
Wrist denervation addresses symptomatic wrist pain without the morbidity and complication profile of more extensive surgical procedures aimed to correct the underlying pathology. The concept of wrist denervation is not new, but its practical application has been modified over the past 50 years. A variety of techniques have been described for various indications, with generally good results. In the United States, a simple, single incision partial denervation consisting of neurectomies of the anterior and posterior interosseous nerves is most commonly performed. Although data on this procedure are limited, most patients are satisfied with pain relief in the short term. There is no evidence that partial denervation procedures alter proprioception of the wrist, and this procedure shows promise as a good option for palliating pain without prolonged postoperative immobilization or leave from work. Preoperative injections do not seem to correlate well with postoperative results. Future studies are needed to assess the duration of relief and possible acceleration of underlying pathology.
腕部去神经支配术可解决有症状的腕部疼痛，而无需采用旨在纠正潜在病理状况的更广泛外科手术所带来的发病率和并发症。腕部去神经支配术的概念并不新鲜，但在过去50年里其实际应用有所改变。针对各种适应症描述了多种技术，总体效果良好。在美国，最常施行的是一种简单的单切口部分去神经支配术，包括对骨间前神经和骨间后神经进行神经切除术。尽管关于该手术的数据有限，但大多数患者对短期疼痛缓解感到满意。没有证据表明部分去神经支配术会改变腕部的本体感觉，并且该手术有望成为缓解疼痛的良好选择，无需长时间术后固定或停工。术前注射似乎与术后结果相关性不佳。需要进一步的研究来评估缓解的持续时间以及潜在病理状况可能的加速发展情况。
