Daugherty Timothy H F, Bueno Reuben A, Neumeister Michael W
Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.
Plast Reconstr Surg Glob Open. 2019 Aug 8;7(8):e2376. doi: 10.1097/GOX.0000000000002376. eCollection 2019 Aug.
Targeted muscle reinnervation (TMR) has been shown to decrease neuroma pain after major limb loss; however, it has not previously been described for the treatment of symptomatic neuromas in the hand after digit amputations. This report describes the use of TMR in the hand for treatment of a patient with recurrent neuromas after ray amputation of the index and long fingers that were refractory to traditional treatments. TMR was performed first for the superficial branch of the radial nerve 6 years ago to treat the dorsal neuroma pain. Following this, there was complete resolution on the dorsal aspect of the hand, however, continued neuroma pain on the volar aspect of the hand. This was treated more recently with excision of the neuromas and TMR to motor branches of the intrinsic muscles of the hand. Outcomes were measured with a numerical rating scale and Patient-Reported Outcomes Measurement System assessments and revealed decreased pain postoperatively and less interference of her activities due to pain. This report demonstrates the ability to perform TMR within the hand with good results when used for the treatment of symptomatic neuromas.
靶向肌肉再支配术（TMR）已被证明可减轻大肢体缺失后的神经瘤疼痛；然而，此前尚未有关于其用于治疗手指截肢后手的症状性神经瘤的描述。本报告介绍了TMR在手部的应用，用于治疗示指和中指射线截肢后复发性神经瘤且对传统治疗无效的患者。6年前首次对桡神经浅支进行TMR以治疗手背神经瘤疼痛。此后，手背疼痛完全缓解，但手掌仍持续存在神经瘤疼痛。最近通过切除神经瘤并对手部固有肌运动支进行TMR来治疗。通过数字评分量表和患者报告结局测量系统评估来衡量结果，结果显示术后疼痛减轻，疼痛对其活动的干扰减少。本报告证明了在手内进行TMR治疗症状性神经瘤时能取得良好效果。
