[The square pronator: an "aspirin" strip in antalgic surgery for painful neuromas of the wrist].
From June 96 to January 2001, 25 patients have been operated on for painful neuromas localised at the wrist. They were between 10 and 52 years of age. These neuromas were located in at the median nerve 17 cases, at the ulnar nerve in seven cases and at the radial nerve in one case. In all cases the pain was not spontaneous but triggered off by external stimulus. All these neuromas were in continuity except 1 case at the median nerve where a total severing was present. After external neurolysis, the quadratus pronatus muscle is wrapped around the neuromas in 24 cases and around epineurial suture in one case. No internal neurolysis was done. This flap was vascularized by the anterior interosseous artery in 23 cases and by the posterior interosseous artery in two cases of distal ulnar nerve neuroma. All patients have been improved by using this method. In 21 cases (84%) (17 median, 4 ulnar nerves) the pain has completely disappeared and in four cases (3 ulnar, 1 radial), the pain has considerably decreased but without total disappearance. In the cases of median nerve neuromas the dysaesthesia has greatly decreased. No complications and no sequelae on the donor site are reported.
Service de chirurgie plastique et chirurgie de la main, hôpital Avicenne, Rabat, Maroc. belmahi@wanadoo.net.ma
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A
Belmahi
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Amrani
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Gharib
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Abbassi
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D009463:Neuroma / Q000473:pathology / Q000601:surgery*; D010146:Pain; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology / Q000601:surgery*; D011826:Radial Nerve / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000473:pathology / Q000601:surgery; D014953:Wrist / Q000294:innervation* / Q000473:pathology / Q000601:surgery