Moradian Simon, Taritsa Iulianna C, Sharma Sripadh, Mioton Lauren, Dumanian Gregory A, Ko Jason H
From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2024 Apr 15;12(4):e5742. doi: 10.1097/GOX.0000000000005742. eCollection 2024 Apr.
Targeted muscle reinnervation (TMR), a surgical technique developed by the senior authors that coapts proximal ends of nerves to distal motor nerves of adjacent muscles, has demonstrated efficacy in the treatment and prevention of neuroma pain. The objective of this study is to describe the surgical technique for TMR of the superficial peroneal nerve (SPN) and deep peroneal nerve (DPN) in nonamputee patients and provide data on postoperative functional outcomes.
A single-institution retrospective chart review was performed between March 2018 and April 2021. Patients were de-identified and included if they were nonamputees receiving TMR for pain in the peroneal nerve distribution. Data extracted included demographic information, symptoms before operation, relevant nerve coaptation, peri-, and postoperative complications, and long-term functional outcomes.
Of the 19 patients reviewed, 11 patients underwent TMR of the SPN alone: eight had complete resolution of their symptoms; two indicated partial improvement in pain; and one patient had no improvement. Four patients underwent TMR of the DPN alone: two patients had complete resolution of their pain, and two patients had partial improvement with pain. Four patients underwent TMR of both the SPN/DPN: two patients had complete resolution of their symptoms, and two patients were noted to have significant improvement but had persistent pain from prior foot operations. Average follow-up time was 260 days.
TMR is a successful technique in the management of SPN and DPN neuroma pain. Our technique revealed excellent clinical outcomes, no procedure-specific complications, and improved subjective pain reports.
靶向肌肉再支配术（TMR）是资深作者开发的一种外科技术，该技术将神经近端与相邻肌肉的远端运动神经进行吻合，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非截肢患者腓浅神经（SPN）和腓深神经（DPN）的TMR手术技术，并提供术后功能结果的数据。
2018年3月至2021年4月在单一机构进行了回顾性病历审查。对患者进行去识别处理，如果他们是非截肢患者且因腓神经分布区疼痛接受TMR手术，则纳入研究。提取的数据包括人口统计学信息、术前症状、相关神经吻合情况、围手术期和术后并发症以及长期功能结果。
在审查的19例患者中，11例仅接受了SPN的TMR手术：8例症状完全缓解；2例表示疼痛部分改善；1例患者无改善。4例仅接受了DPN的TMR手术：2例患者疼痛完全缓解，2例患者疼痛部分改善。4例接受了SPN/DPN的TMR手术：2例患者症状完全缓解，2例患者有显著改善，但仍因既往足部手术存在持续性疼痛。平均随访时间为260天。
TMR是治疗SPN和DPN神经瘤疼痛的一种成功技术。我们的技术显示出优异的临床结果，无特定手术并发症，主观疼痛报告有所改善。
