title: Ischemic rest pain of the lower extremities. Treatment with peripheral nerve crush.
abstract: The authors report the results obtained from peripheral nerve crushing in the treatment of ischemic rest pain and/or trophic lesions of toes and feet. They studied retrospectively 102 patients who were submitted to peripheral nerve crushing at the "Hospital das Clínicas da Universidade de São Paulo" during a sixteen-year period, from March 1971 to April 1987. These patients had no other choice, either clinical or surgical. The results were evaluated under three aspects: elimination of pain, evolution of trophic lesions and postoperative complications. The follow-up period varied from 1 month to 6 years (mean of 18 months). The results showed immediate elimination of pain in 94% of the patients. The remaining 6% were reoperated on within 24 to 48 hours, due to technical failure in identifying some of the nerves during the first operation. Regarding the trophic lesions, in 71% of the patients the results were good and the remaining underwent amputation at leg or thigh. The worst results were obtained in patients with necrotic lesions (p < 0.05). Three patients presented surgical wound dehiscence. The authors conclude that peripheral nerve crushing constitutes a valid alternative for a select group of patients with uncontrollable ischemic rest pain in the feet.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
authors.forename: B
authors.initials: B
authors.lastname: Muraco Neto
authors.forename: N
authors.initials: N
authors.lastname: Wolosker
authors.forename: P
authors.initials: P
authors.lastname: Kauffman
authors.forename: R
authors.initials: R
authors.lastname: Aun
authors.forename: S
authors.initials: S
authors.lastname: Kuzniek
authors.forename: P C
authors.initials: PC
authors.lastname: Guimarães
authors.forename: B
authors.initials: B
authors.lastname: Langer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001162:Arteriosclerosis Obliterans / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009409:Nerve Crush; D010146:Pain / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013919:Thromboangiitis Obliterans / Q000503:physiopathology