Neuroma-in-continuity of the median nerve managed by nerve expansion and direct suture with vein conduit.
Autologous nerve grafting is the current standard for bridging large gaps in major sensory and motor nerves. It allows both function and pain improvement with predictable results. Clinical observations of nerve elongation caused by tumours have prompted experimental animal studies of induced gradual elongation of the nerve stump proximal to the gap. This technique allows direct suturing of the two nerve ends to bridge the gap. Here, we describe a case of neuroma-in-continuity of the median nerve managed by resection and direct suture after nerve elongation with a tissue expander. We are not aware of similar reported cases. Secondary repair 3 years after the initial injury improved the pain and hypersensitivity and restored a modest degree of protective sensory function (grade S1).
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France. Electronic address: jeudy@centredelamain.fr.
J
J
Jeudy
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
G
G
Raimbeau
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
F
F
Rabarin
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
P A
PA
Fouque
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
Y
Y
Saint-Cast
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
B
B
Césari
Centre de la main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France.
N
N
Bigorre
D000328:Adult; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008475:Median Nerve / Q000601:surgery*; D055164:Nerve Expansion / Q000379:methods*; D009423:Nervous System Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009463:Neuroma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D012086:Reoperation; D013537:Sutures; D015625:Tissue Expansion Devices; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery / Q000637:transplantation*
Elongation; Expansion; Gap; Nerve; Neuroma