Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity
Background:. We present a novel technique for the management of intractable lower extremity pain, due to neuromas-in-continuity of two peripheral nerves, through combined neurectomies proximal to the zone of initial injury and subsequent bridging utilizing an allograft-coupled conduit construct. Met...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003867 |
| _version_ | 1818931649783529472 |
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| author | Edgardo Rodriguez-Collazo, DPM Kaitlyn Laube Ward, DPM |
| author_facet | Edgardo Rodriguez-Collazo, DPM Kaitlyn Laube Ward, DPM |
| author_sort | Edgardo Rodriguez-Collazo, DPM |
| collection | DOAJ |
| description | Background:. We present a novel technique for the management of intractable lower extremity pain, due to neuromas-in-continuity of two peripheral nerves, through combined neurectomies proximal to the zone of initial injury and subsequent bridging utilizing an allograft-coupled conduit construct.
Methodology:. A retrospective chart review of 36 patients (18 women and 18 men) with recalcitrant nerve pain secondary to neuromas-in-continuity of two peripheral nerves following lower extremity trauma was conducted. Subjects underwent superficial peroneal nerve (SPN) to deep peroneal nerve neurorrhaphy (19 patients) or SPN to sural nerve neurorrhaphy (17 patients) proximal to the zone of initial injury. Patient demographics, comorbidities, procedure details, complications, and preoperative and postoperative pain assessments using a visual analog scale were evaluated.
Results:. Residual nerve pain from previous lower extremity trauma was included. Analysis of preprocedure and postprocedure visual analog scale scores demonstrated a mean decrease of 7.45 points (mean: pre 8.89, mean: post 1.44). All patients voiced satisfaction with postoperative ambulatory tolerance and pain relief at last follow-up (mean: 30.86 months).
Conclusions:. The sequelae of neuromas-in-continuity of the SPN, deep peroneal nerve, and sural nerves were noted to have significantly improved with proximal neurectomy and subsequent bridging utilizing a nerve allograft and conduit construct. We present this coaptation technique as a viable treatment option for reduction in neurogenic pain involving peripheral nerve injury of two dermatome distributions. |
| first_indexed | 2024-12-20T04:19:57Z |
| format | Article |
| id | doaj.art-f119bcfd97a14d18ae1de88531feff07 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-20T04:19:57Z |
| publishDate | 2021-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-f119bcfd97a14d18ae1de88531feff072022-12-21T19:53:40ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-11-01911e386710.1097/GOX.0000000000003867202111000-00002Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuityEdgardo Rodriguez-Collazo, DPM0Kaitlyn Laube Ward, DPM1From the Department of Surgery, AMITA Health St. Joseph Hospital, Chicago, Ill.From the Department of Surgery, AMITA Health St. Joseph Hospital, Chicago, Ill.Background:. We present a novel technique for the management of intractable lower extremity pain, due to neuromas-in-continuity of two peripheral nerves, through combined neurectomies proximal to the zone of initial injury and subsequent bridging utilizing an allograft-coupled conduit construct. Methodology:. A retrospective chart review of 36 patients (18 women and 18 men) with recalcitrant nerve pain secondary to neuromas-in-continuity of two peripheral nerves following lower extremity trauma was conducted. Subjects underwent superficial peroneal nerve (SPN) to deep peroneal nerve neurorrhaphy (19 patients) or SPN to sural nerve neurorrhaphy (17 patients) proximal to the zone of initial injury. Patient demographics, comorbidities, procedure details, complications, and preoperative and postoperative pain assessments using a visual analog scale were evaluated. Results:. Residual nerve pain from previous lower extremity trauma was included. Analysis of preprocedure and postprocedure visual analog scale scores demonstrated a mean decrease of 7.45 points (mean: pre 8.89, mean: post 1.44). All patients voiced satisfaction with postoperative ambulatory tolerance and pain relief at last follow-up (mean: 30.86 months). Conclusions:. The sequelae of neuromas-in-continuity of the SPN, deep peroneal nerve, and sural nerves were noted to have significantly improved with proximal neurectomy and subsequent bridging utilizing a nerve allograft and conduit construct. We present this coaptation technique as a viable treatment option for reduction in neurogenic pain involving peripheral nerve injury of two dermatome distributions.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003867 |
| spellingShingle | Edgardo Rodriguez-Collazo, DPM Kaitlyn Laube Ward, DPM Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity Plastic and Reconstructive Surgery, Global Open |
| title | Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity |
| title_full | Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity |
| title_fullStr | Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity |
| title_full_unstemmed | Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity |
| title_short | Conduit-assisted Allograft Neurorrhaphy for the Treatment of Intractable Lower Extremity Pain Due to Neuromas-in-continuity |
| title_sort | conduit assisted allograft neurorrhaphy for the treatment of intractable lower extremity pain due to neuromas in continuity |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003867 |
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