Hones Keegan M, Nichols David Spencer, Barker Haley, Cox Elizabeth, Hones Jaime A, Chim Harvey
University of Florida Collage of Medicine, Gainesville, FL, United States.
Department of Plastic and Reconstructive Surgery, University of Florida, Gainesville, FL, United States.
Front Surg. 2023 Mar 21;10:1123375. doi: 10.3389/fsurg.2023.1123375. eCollection 2023.
Epineural scarring following previous carpal or cubital tunnel release can lead to pain and permanent dysfunction. To prevent this cascade, nerve wraps are an option. The purpose of this study was to evaluate outcomes following use of VersaWrap nerve protector during surgical decompression and neurolysis in patients with recurrent compressive neuropathies in the upper extremity. Twenty patients comprised the patient cohort, with a mean postoperative follow-up time of 139 days (range: 42-356 days). There were 13 females and 7 males, with a mean age of 43.4 years. Fourteen surgeries were performed for revision cubital tunnel, 5 for revision carpal tunnel, and 1 for revision radial tunnel syndrome. Average duration of symptoms prior to revision surgery with VersaWrap was 2 years (range 9 months to 6 years). Postoperatively, the mean DASH score was 57.7 and VAS 3.1. Mean s2PD median distribution was 7.3, s2PD ulnar distribution 8.9, m2PD median distribution 6.9 and m2PD ulnar distribution 7.3. All patients had subjective improvement of symptoms and were satisfied with their result. No patients in our cohort required further revisional surgery. In conclusion, the use of VersaWrap as a nerve protector following revision surgery for recurrent compressive neuropathies in the upper extremity was safe and effective. IV; retrospective case series.
先前腕管或肘管松解术后的神经外膜瘢痕形成可导致疼痛和永久性功能障碍。为防止这种情况发生，神经包裹物是一种选择。本研究的目的是评估在上肢复发性压迫性神经病患者的手术减压和神经松解过程中使用VersaWrap神经保护器后的效果。20名患者组成了研究队列，术后平均随访时间为139天（范围：42 - 356天）。其中女性13名，男性7名，平均年龄43.4岁。14例手术为肘管翻修术，5例为腕管翻修术，1例为桡管综合征翻修术。使用VersaWrap进行翻修手术前症状的平均持续时间为2年（范围9个月至6年）。术后，平均DASH评分为57.7，视觉模拟评分（VAS）为3.1。平均s2PD中位数分布为7.3，s2PD尺侧分布为8.9，m2PD中位数分布为6.9，m2PD尺侧分布为7.3。所有患者症状均有主观改善，对结果满意。我们队列中没有患者需要进一步的翻修手术。总之，在上肢复发性压迫性神经病翻修手术后使用VersaWrap作为神经保护器是安全有效的。IV；回顾性病例系列。
