Prevention of painful neuromas by epineural ligatures, flaps and grafts.
Neuroma formation at the proximal end of a divided nerve is a common problem in peripheral nerve surgery. Forty-eight nerve endings in 23 patients with traumatic or post-elective surgery amputation stumps were capped with either an epineural ligature, epineural flaps or an epineural graft. Each technique was used on 16 nerve endings. After at least 6 months follow-up, pain at the nerve endings was assessed by tapping the treatment sites and asking the patients to score their pain on a visual analogue scale (VAS) from 0 to 10. The mean VAS scores were 5.18 for epineural ligatures, 4.25 for epineural flaps and 2.06 for epineural grafts. Epineural grafts were significantly more effective in preventing neuroma pain (ANOVA: F = 11.4, P < 0.05).
Yüksel
F
F
Department of Plastic and Reconstructive Surgery, GATA Haydarpaşa Training Hospital, Kadiköy-Istanbul, Turkey.
Kişlaoğlu
E
E
Durak
N
N
Uçar
C
C
Karacaoğlu
E
E
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects* / Q000379:methods*; D000673:Amputation, Traumatic / Q000150:complications*; D001132:Arm / Q000294:innervation*; D005385:Fingers / Q000601:surgery; D005500:Follow-Up Studies; D006225:Hand / Q000601:surgery; D006801:Humans; D008026:Ligation / Q000379:methods; D008875:Middle Aged; D009463:Neuroma / Q000209:etiology / Q000517:prevention & control*; D010525:Peripheral Nerves / Q000601:surgery / Q000637:transplantation; D013524:Surgical Flaps / Q000379:methods