Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis
• Purpose: Partial wrist denervation can be performed by isolated posterior interosseous nerve (PIN) or combined PIN plus (+) anterior interosseous nerve (AIN) neurectomy procedures. • The purpose of the current systematic review is to investigate any differences in clinical outcomes and failures i...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-03-01
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| Series: | EFORT Open Reviews |
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| Online Access: | https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0089.xml |
| _version_ | 1797870171493236736 |
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| author | Andrea Fidanza Stefano Necozione Lorenzo Garagnani |
| author_facet | Andrea Fidanza Stefano Necozione Lorenzo Garagnani |
| author_sort | Andrea Fidanza |
| collection | DOAJ |
| description | • Purpose: Partial wrist denervation can be performed by isolated posterior interosseous nerve (PIN) or combined PIN plus (+) anterior interosseous nerve (AIN) neurectomy procedures.
• The purpose of the current systematic review is to investigate any differences in clinical outcomes and failures in patients undergoing AIN + PIN vs isolated PIN neurectomy.
• Methods: A review of the English Literature was performed on Medline, WOS and Scopus according to PRISMA protocol combining ‘wrist denervation’, ‘PIN neurectomy’, ‘AIN neurectomy’, anterior interosseous nerve neurectomy’ and ‘posterior interosseous nerve neurectomy’. Studies were assessed with a modified Coleman Methodology Score (CMS).
The primary outcome for meta-analysis was ‘Failures’, including all patients who have required a second surgery or those who are left with pain (defined as ‘bad’).
• Results: Overall, 10 studies totalling 347 wrists were included in this systematic review, with a ‘moderate’ CMS. The isolated PIN neurectomy technique showed a 15.1% pooled failure rate at a median follow-up of 22 months, while the combined AIN+PIN denervation had a pooled failure rate of 23.6% at a follow-up with a median of 29 months. The combined analysis of both procedures did not show significantly better results in favour of either technique, with a general failure rate of 21.6% (P = 0.0501).
• Conclusion: Partial denervation for chronic wrist pain is a salvage procedure that leads to an overall success of 78.4% for pain relief, with no substantial complications. Apparently, performing the neurectomy also of the AIN does not offer greater advantages compared to the isolated PIN neurectomy. |
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| format | Article |
| id | doaj.art-5c1db6a7e7c746789c0555e6d5ab2603 |
| institution | Directory Open Access Journal |
| issn | 2058-5241 |
| language | English |
| last_indexed | 2024-04-10T00:24:12Z |
| publishDate | 2023-03-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | EFORT Open Reviews |
| spelling | doaj.art-5c1db6a7e7c746789c0555e6d5ab26032023-03-15T11:51:39ZengBioscientificaEFORT Open Reviews2058-52412023-03-0183110116https://doi.org/10.1530/EOR-22-0089Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysisAndrea Fidanza0Stefano Necozione1Lorenzo Garagnani2Unit of Orthopaedics and Traumatology - Department of life, Health & Environmental Sciences, University of L’Aquila, Italy; Hand Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UKUnit of Clinical Epidemiology - Department of life, Health & Environmental Sciences, University of L’Aquila, ItalyHand Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King’s College London, London, UK • Purpose: Partial wrist denervation can be performed by isolated posterior interosseous nerve (PIN) or combined PIN plus (+) anterior interosseous nerve (AIN) neurectomy procedures. • The purpose of the current systematic review is to investigate any differences in clinical outcomes and failures in patients undergoing AIN + PIN vs isolated PIN neurectomy. • Methods: A review of the English Literature was performed on Medline, WOS and Scopus according to PRISMA protocol combining ‘wrist denervation’, ‘PIN neurectomy’, ‘AIN neurectomy’, anterior interosseous nerve neurectomy’ and ‘posterior interosseous nerve neurectomy’. Studies were assessed with a modified Coleman Methodology Score (CMS). The primary outcome for meta-analysis was ‘Failures’, including all patients who have required a second surgery or those who are left with pain (defined as ‘bad’). • Results: Overall, 10 studies totalling 347 wrists were included in this systematic review, with a ‘moderate’ CMS. The isolated PIN neurectomy technique showed a 15.1% pooled failure rate at a median follow-up of 22 months, while the combined AIN+PIN denervation had a pooled failure rate of 23.6% at a follow-up with a median of 29 months. The combined analysis of both procedures did not show significantly better results in favour of either technique, with a general failure rate of 21.6% (P = 0.0501). • Conclusion: Partial denervation for chronic wrist pain is a salvage procedure that leads to an overall success of 78.4% for pain relief, with no substantial complications. Apparently, performing the neurectomy also of the AIN does not offer greater advantages compared to the isolated PIN neurectomy.https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0089.xmlwristpainarthritisupper limb functionhand |
| spellingShingle | Andrea Fidanza Stefano Necozione Lorenzo Garagnani Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis EFORT Open Reviews wrist pain arthritis upper limb function hand |
| title | Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis |
| title_full | Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis |
| title_fullStr | Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis |
| title_full_unstemmed | Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis |
| title_short | Does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain? A systematic review of the literature and meta-analysis |
| title_sort | does anterior plus posterior interosseus neurectomy lead to better outcomes than isolated posterior interosseus denervation in the treatment of chronic wrist pain a systematic review of the literature and meta analysis |
| topic | wrist pain arthritis upper limb function hand |
| url | https://eor.bioscientifica.com/view/journals/eor/8/3/EOR-22-0089.xml |
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