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射频消融治疗神经瘤疼痛。

Radiofrequency Ablation for the Treatment of Painful Neuroma.

机构信息

Assistant Professor, Division of Foot/Ankle Surgery and Biomechanics, Kent State University College of Podiatric Medicine, Independence, OH.

Dean-CEO, Professor, Division of Podiatric Surgery, Kent States University College of Podiatric Medicine, Independence, OH.

出版信息

J Foot Ankle Surg. 2020 May-Jun;59(3):457-461. doi: 10.1053/j.jfas.2019.09.003.

Abstract

Mechanical compression of interdigital nerves beneath the deep transverse intermetatarsal ligament and between the metatarsal heads leads to painful irritation and possible fibrosis. Conservative measures of padding and injections often fail to provide long-term relief. Surgical excision provides definitive relief, but the procedure is not without risk. Incomplete excision and stump neuroma formation are a few of the possible complications associate with open excision. This retrospective cohort study was performed to provide a review of the available literature on the identification and treatment of interdigital neuromas and to examine the overall incidence of patient satisfaction after radiofrequency ablation as definitive treatment for interdigital neuroma formation. This study population consisted of 32 patients (25 females and 7 males with 1 patient having bilateral procedures) with a mean age of 46.3 ± 17 (range 31 to 65) years. For all procedures, the median patient satisfaction score was 92.5 (interquartile range 50 to 100) of 100, with a mean follow-up period of > 2.5 years. Only 1 patient in the study population reported no relief after 3 total procedures. Radiofrequency ablation offers a minimally invasive alternative with a short postoperative recovery course and considerably fewer complications compared with surgical excision of the intermetatarsal neuroma as described in prior reports.

摘要

在深横骨间韧带下和跖骨间,指间神经受到机械性压迫,导致疼痛刺激和可能的纤维化。衬垫和注射等保守治疗措施往往无法提供长期缓解。手术切除可以提供明确的缓解,但该手术并非没有风险。不完全切除和残端神经瘤形成是与开放性切除相关的一些可能并发症。这项回顾性队列研究旨在回顾指间神经瘤的识别和治疗的现有文献,并检查射频消融作为指间神经瘤形成的明确治疗方法的总体患者满意度。该研究人群包括 32 名患者(25 名女性和 7 名男性,1 名患者进行双侧手术),平均年龄为 46.3 ± 17 岁(范围为 31 至 65 岁)。对于所有手术,中位数患者满意度评分为 100 分中的 92.5 分(四分位间距 50 至 100),平均随访时间超过 2.5 年。研究人群中只有 1 名患者在 3 次总手术后仍未得到缓解。与先前报道的手术切除跖间神经瘤相比,射频消融术提供了一种微创替代方案,具有较短的术后恢复过程和明显更少的并发症。

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