Abstract:In the setting of recalcitrant neuromas and intractable pain following multiple neuroma excisions, allografts may be suboptimal in reconstruction of larger gap defects. Autologous reconstruction with porcine submucosa extracellular matrix, as in this case, can avoid tethering, local ischemia, and nerve traction to optimize outcomes.
“…Finger injury is the most common type of injury in children in emergency department, which has a certain impact on their body and mind [1,2]. Although most children have mild finger injuries, severe finger injuries still need surgical treatment [3,4] and may lead to serious complications such as infection, soft tissue defect, fracture nonunion, and ampu-tation, resulting in serious sequelae such as finger deformity, nail dysplasia, and intractable pain [5][6][7].…”
Objective. After replantation of severed fingers in infants, the utility model patent upper limb restrictive brace-assisted bed rest braking, combined with psychological intervention, can alleviate children’s anxiety, so as to reduce the occurrence of vascular crisis. Methods. The study period was from April 2015 to July 2018. In this paper, 30 children with finger injuries in hand surgery in the CIS electronic medical record system of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects. Replantation was performed in 30 infants with severed fingers. Among them, 15 cases were applied with the method of aircraft chest arm gypsum splint combined with sedative drug braking and the utility model patented product upper limb restrictive brace fixation-assisted bed rest braking, and the method of psychological intervention was applied at the same time. Results. Among the 15 fingers in the control group, 6 had vascular crisis and 1 in the experimental group. The incidence of vascular crisis in the experimental group was lower, and the difference between the two groups was statistically significant (
P
<
0.05
). The patients were followed up for 9~18 months, with an average of
9.72
±
1.07
months. In the control group, 15 cases of severed fingers survived, and there were 13 cases of replantation finger necrosis in 2 cases of intractable arterial crisis. In the experimental group, 14 cases of severed fingers survived in 15 cases and there was 1 case of replanted finger necrosis in intractable arterial crisis after operation. There was no significant difference in the survival rate between the two groups (
P
>
0.05
). In addition, the replanted finger function was evaluated. In the control group, 9 cases were excellent, 4 cases were good, and 1 case was fair. In the experimental group, 14 cases were excellent, 1 case was good, and 0 case was fair. The functional evaluation of the experimental group was better than that of the control group, and the difference between the two groups was statistically significant (
P
<
0.05
). Conclusion. For infants after replantation of severed fingers, the application of the utility model patented product upper limb restrictive brace can effectively make up for the insufficient fixation of aircraft chest arm gypsum splint, reduce the occurrence of vascular crisis, and assist children in bed. In addition, the application of psychological intervention can reduce children’s postoperative crying and is conducive to children’s postoperative recovery.
“…Finger injury is the most common type of injury in children in emergency department, which has a certain impact on their body and mind [1,2]. Although most children have mild finger injuries, severe finger injuries still need surgical treatment [3,4] and may lead to serious complications such as infection, soft tissue defect, fracture nonunion, and ampu-tation, resulting in serious sequelae such as finger deformity, nail dysplasia, and intractable pain [5][6][7].…”
Objective. After replantation of severed fingers in infants, the utility model patent upper limb restrictive brace-assisted bed rest braking, combined with psychological intervention, can alleviate children’s anxiety, so as to reduce the occurrence of vascular crisis. Methods. The study period was from April 2015 to July 2018. In this paper, 30 children with finger injuries in hand surgery in the CIS electronic medical record system of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects. Replantation was performed in 30 infants with severed fingers. Among them, 15 cases were applied with the method of aircraft chest arm gypsum splint combined with sedative drug braking and the utility model patented product upper limb restrictive brace fixation-assisted bed rest braking, and the method of psychological intervention was applied at the same time. Results. Among the 15 fingers in the control group, 6 had vascular crisis and 1 in the experimental group. The incidence of vascular crisis in the experimental group was lower, and the difference between the two groups was statistically significant (
P
<
0.05
). The patients were followed up for 9~18 months, with an average of
9.72
±
1.07
months. In the control group, 15 cases of severed fingers survived, and there were 13 cases of replantation finger necrosis in 2 cases of intractable arterial crisis. In the experimental group, 14 cases of severed fingers survived in 15 cases and there was 1 case of replanted finger necrosis in intractable arterial crisis after operation. There was no significant difference in the survival rate between the two groups (
P
>
0.05
). In addition, the replanted finger function was evaluated. In the control group, 9 cases were excellent, 4 cases were good, and 1 case was fair. In the experimental group, 14 cases were excellent, 1 case was good, and 0 case was fair. The functional evaluation of the experimental group was better than that of the control group, and the difference between the two groups was statistically significant (
P
<
0.05
). Conclusion. For infants after replantation of severed fingers, the application of the utility model patented product upper limb restrictive brace can effectively make up for the insufficient fixation of aircraft chest arm gypsum splint, reduce the occurrence of vascular crisis, and assist children in bed. In addition, the application of psychological intervention can reduce children’s postoperative crying and is conducive to children’s postoperative recovery.
“…3 ). 14 , 15 , 16 , 17 , 18 While numerous techniques have been described to treat painful neuromas, the optimal surgical technique for management and treatment of neuroma patients remains elusive. 27 Figure 3 Neuroma pain that is amenable to surgery.…”
Section: Neuroma Painmentioning
confidence: 99%
“…Painful neuromas represent perhaps the best understood neuralgic phenomena. 14 , 15 , 16 , 17 , 18 Studies led by Campbell et al 15 on neuroma pathophysiology showed ephaptic conduction within the neuroma that was mechanically sensitive but also spontaneously active; this pathophysiologic phenomenon resonates with the clinical narratives given by those with neuroma pain. An injury with Sunderland degree V—complete transection—is a typical neuroma, with degree IV representing a neuroma in continuity (with potential for a degree VI mixed injury in the nerve in this context).…”
Neuralgia, or nerve pain, is a common presenting complaint for the hand surgeon. When the nerve at play is easily localized, and the cause of the pain is clear (eg, carpal tunnel syndrome), the patient may be easily treated with excellent results. However, in more complex cases, the underlying pathophysiology and cause of neuralgia can be more difficult to interpret; if incorrectly managed, this leads to frustration for both the patient and surgeon. Here we offer a way to conceptualize neuralgia into 4 categoriesdcompression neuropathy, neuroma, painful hyperalgesia, and phantom nerve paindand offer an illustrative clinical vignette and strategies for optimal management of each. Further, we delineate the reasons why compression neuropathy and neuroma are amenable to surgery, while painful hyperalgesia and phantom nerve pain are not.
“…In digital nerves, frequently seen after amputation, simple shortening and burring nerve end can be satisfactory. In recurrent cases or other techniques are proposed including end-to-side suture of injured nerve to the healthy one, introducing the nerve end into the bone or use of allografts (Sosin et al, 2016).…”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
