Sgromolo Nicole M, Cho Mickey S, Gower Joseph T, Rhee Peter C
Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX.
Central Jersey Hand Surgery, Eatontown, NJ.
J Hand Surg Am. 2018 Dec;43(12):1108-1112. doi: 10.1016/j.jhsa.2018.05.018. Epub 2018 Jun 21.
Treating dorsal wrist pain of unknown etiology provides a challenge to the most experienced hand surgeon. Therefore, we conducted a study aimed to determine outcomes of patients undergoing a posterior interosseous nerve (PIN) or anterior/posterior interosseous nerve (AIN/PIN) neurectomy for wrist pain without a known cause, in patients who responded to preoperative injection.
A retrospective chart review was performed of all active duty patients undergoing isolated PIN or AIN/PIN neurectomy for idiopathic dorsal wrist pain with a documented response to preoperative injection between December 2011 and April 2017. Demographic data, return to duty status, pain scores, and range of motion were among the data collected and reviewed.
The initial search yielded 108 patients of whom 13 met inclusion criteria for our study. Overall, only 2 of 13 patients were able to return to full duty without restrictions, 5 went on to medical discharge, and 6 were placed on permanent duty restrictions. No patients within our study were deployed. Patients had improvement in their pain scores from 4.0 to 2.2. Range of motion was similar before and after surgery.
A PIN or AIN/PIN neurectomy resulted in improvement in pain scores in patients, but was not successful in returning the majority of patient to full active duty status without restrictions.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
治疗病因不明的腕背疼痛对经验最丰富的手外科医生来说都是一项挑战。因此，我们开展了一项研究，旨在确定对术前注射有反应的、病因不明的腕部疼痛患者接受骨间后神经（PIN）或骨间前/后神经（AIN/PIN）切除术的疗效。
对2011年12月至2017年4月期间所有因特发性腕背疼痛接受单纯PIN或AIN/PIN切除术且术前注射有明确反应的现役患者进行回顾性病历审查。收集并审查的数据包括人口统计学数据、重返工作岗位状态、疼痛评分和活动范围。
初步检索得到108例患者，其中13例符合我们研究的纳入标准。总体而言，13例患者中只有2例能够无限制地重返全职工作，5例因伤退役，6例被安排长期工作限制。我们研究中的患者均未被部署。患者的疼痛评分从4.0改善至2.2。手术前后活动范围相似。
PIN或AIN/PIN切除术可使患者疼痛评分得到改善，但未能使大多数患者无限制地重返全职工作状态。
研究类型/证据水平：治疗性IV级。
