[Is surgery likely to be successful as a treatment for traumatic lesions of the superficial radial nerve?].
In the last 10 years 22 patients with lesions of the superficial branch of the radial nerve have been treated surgically in our neurosurgical department. The patients' main complaints were burning pain and paraesthesia in the region supplied by the superficial branch of the radial nerve. In most cases the lesion was due to tendolysis performed earlier to treat de Quervain tendovaginitis stenosans. In 8 cases external neurolysis was done with conservation of continuity; in 4 cases the nerve was reconstructed after resection of the neuroma (end-to-end-suture or implantation of a vicryl conduit); and in 10 cases the neuroma was resected and transposition of the proximal nerve end was performed. Nineteen patients were available for evaluation of the postoperative results, after an average follow-up of 51 months. Surprisingly, only 5 reported good subjective improvement of pain after surgery. Seven patients reported an unchanged status postoperatively, and in 1 case the pain was even worse after the surgical intervention. Satisfactory results (complete or partial pain relief in 75% of cases) was found to have been achieved in the subgroup of patients treated by resection of the neuroma of the superficial branch of the radial nerve and transposition of the nerve stump. In conclusion, we recommend caution when surgical interventions are considered for traumatic lesions of the superficial radial nerve, because the prospects of success are limited. In addition, we do not consider nerve reconstruction desirable in these circumstances.
Kandenwein
J A
JA
Klinik für Neurochirurgie der Universität Ulm am BKH Günzburg. julia.kandenwein@medizin.uni-ulm.de
Richter
H-P
HP
Antoniadis
G
G
D006801:Humans; D009463:Neuroma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010524:Peripheral Nervous System Neoplasms / Q000601:surgery*; D011826:Radial Nerve / Q000293:injuries* / Q000601:surgery*; D020425:Radial Neuropathy / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome