Janes Lindsay E, Fracol Megan E, Ko Jason H, Dumanian Gregory A
Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2020 Jan 17;8(1):e2383. doi: 10.1097/GOX.0000000000002383. eCollection 2020 Jan.
Neuroma pain significantly impacts patient quality of life and is associated with unemployment, chronic opioid dependence, and depression. Targeted muscle reinnervation (TMR), a surgical technique that coapts proximal stumps of cut nerves to distal motor nerves of adjacent muscles, has demonstrated efficacy in the treatment and prevention of neuroma pain. The objective of this study was to describe the surgical technique for TMR of the saphenous nerve, while providing a retrospective review. Between January 2015 and December 2018, 18 patients underwent TMR of the saphenous nerve: 1 nonamputee patient with chronic pain after ankle surgery and 17 amputee patients (10 for relief of chronic postamputation neuroma pain and phantom pain and 7 at the time of amputation for of these symptoms). Six patients were lost to follow up; 2 patients had recurrent pain; and 10 patients had reduced or no pain after TMR surgery. TMR is a successful technique for the management of traumatic neuroma pain in both the amputee and nonamputee populations, and in this study, we describe the technique for saphenous nerve TMR.
神经瘤疼痛严重影响患者的生活质量，并与失业、慢性阿片类药物依赖和抑郁症相关。靶向肌肉神经再支配术（TMR）是一种将切断神经的近端残端与相邻肌肉的远端运动神经吻合的外科技术，已证明在治疗和预防神经瘤疼痛方面具有疗效。本研究的目的是描述隐神经TMR的手术技术，并进行回顾性分析。2015年1月至2018年12月期间，18例患者接受了隐神经TMR：1例踝关节手术后慢性疼痛的非截肢患者和17例截肢患者（10例为缓解慢性截肢后神经瘤疼痛和幻肢痛，7例在截肢时为预防这些症状）。6例患者失访；2例患者疼痛复发；10例患者在TMR手术后疼痛减轻或消失。TMR是治疗截肢和非截肢人群创伤性神经瘤疼痛的一种成功技术，在本研究中，我们描述了隐神经TMR技术。
