Treatment of Painful Neuromas of the Hand and Wrist by Relocation into the Pronator Quadratus Muscle

Sood, Manu; Elliot, David

doi:10.1016/s0266-7681(98)80177-0

Cited by 65 publications

(64 citation statements)

References 14 publications

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“…Fourth, the same studies could prove interesting in co-cultures with different substrates, such as skeletal muscle. The results from this could be correlated with the clinical data from painful neuromas, in which stumps have been buried in muscle with benefit (Sood and Elliot 1998).…”

Section: Discussionmentioning

confidence: 87%

“…On the other hand, a lack of the full recovery of sensation in surgical flaps (Lahteenmaki et al 1989;Rath and Green 1991) or skin grafts may be explained by poor trophic influences of factors from the target tissue. Amongst the many treatment modalities of painful neuromas, relocation of the amputated nerve stumps into muscle or bone or "wrapping" of the stump by fat or fascia are recognised as being successful (Jones 1996;Sood and Elliot 1998). This effect may be attributable to the reduced trophic support from these tissues.…”

Section: Introductionmentioning

confidence: 99%

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Influence of human skin injury on regeneration of sensory neurons

Taherzadeh

Otto

Anand

et al. 2003

Cell and Tissue Research

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The regeneration of sensory nerve fibres is regulated by trophic factors released from their target tissue, particularly the basal epidermis, and matrix molecules. Means to modulate this response may be useful for the treatment of neuromas and painful hypertrophic scars and of sensory deficits in skin grafts and flaps. We have developed an in vitro model of sensory neuron regeneration on human skin in order to study the mechanisms of sensory dysfunction in pathological conditions. Adult rat sensory neurons were co-cultured with unfixed cryosections of normal or injured (crushed) human skin for 72 h. Neurons were immunostained for growth-associated protein-43 and the neurite lengths of neuronal cell bodies situated in various skin regions were measured. Two-way analysis of variance was performed. Neurites of sensory cell bodies on epidermis of normal skin were the shortest, with a mean +/- SEM of 75+/-10 micrometer, whereas those of cells on the dermo-epidermal junction were the longest, with a mean +/- SEM of 231+/-18 micrometer. Neurons on the dermo-epidermal junction of injured skin had significantly longer neurites than those on the same region of normal skin (mean +/- SEM = 289+/-21 micrometer). Regeneration of sensory neurons may be influenced by extracellular matrix molecules, matrix-binding growth factors and trophic factors. Altered substrate or trophic factors in injured skin may explain the increase of neurite lengths. This in vitro model may be useful for studying the molecular mechanisms of sensory recovery and the development of neuropathic pain following peripheral nerve injury.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Influence of human skin injury on regeneration of sensory neurons

Taherzadeh

Otto

Anand

et al. 2003

Cell and Tissue Research

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“…The term ''neuropathic pain'' is not typically used to refer to pain following a traumatic UE nerve injury. Many of the outcome studies following nerve injury or surgery included only measures of physical impairment and return to work as a measure of function, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and the studies that did include the DASH 4,6,9 were published more recently.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic Pain in Patients with Upper-Extremity Nerve Injury

Novak

Katz²

2010

Physiotherapy Canada

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Purpose: The purpose of this review was to present an analysis of the literature of the outcome studies reported in patients following traumatic upperextremity (UE) nerve injuries (excluding amputation), to assess the presence of an association between neuropathic pain and outcome in patients following traumatic UE nerve injuries, and to provide recommendations for inclusion of more comprehensive outcome measures by clinicians who treat these patients. Summary of Key Points: A Medline and CINAHL literature search retrieved 48 articles. This review identified very few studies of patients with peripheral nerve injury that reported neuropathic pain. When pain was reported, visual analogue or numeric rating scales were most frequently used; standardized questionnaires measuring pain or psychosocial function were rarely administered. Recent evidence shows substantial long-term disability and pain in patients following peripheral nerve injury. Recommendation: To better understand neuropathic pain in patients following peripheral nerve injury, future outcome studies should include valid, reliable measures of physical impairment, pain, disability, health-related quality of life, and psychosocial functioning.Key Words: literature review, nerve injury, neuropathic pain, outcome Novak CB, Katz J. Neuropathic pain in patients with upper-extremity nerve injury. Physiother Can. 2010;62:190-201. RÉ SUMÉObjectif : L'objectif de cette revue é tait de pré senter une analyse de la documentation portant sur les é tudes ré pertorié es concernant les patients aux prises avec des lé sions nerveuses traumatiques des membres supé rieurs (excluant l'amputation), d'é valuer la pré sence d'un lien entre la douleur né vropathique et les ré sultats attendus chez les patients à la suite de lé sions nerveuses traumatiques des membres supé rieurs et de formuler des recommandations en vue d'inclure le recours à des mesures de rendement plus complè tes par les cliniciens traitant ces patients. Ré sumé des principales é tapes : Une recherche documentaire dans Medline et dans CINAHL a permis de ré pertorier 48 articles. Cette recherche a permis de constater que parmi les patients souffrant de lé sions nerveuses pé riphé riques é tudié s, trè s peu avaient signalé des douleurs né vropathiques. Lorsque de la douleur é tait signalé e, des é chelles de mesure numé riques ou des é chelles visuelles analogues é taient utilisé es le plus fré quemment et l'on faisait rarement appel à des questionnaires normalisé s pour é valuer la douleur ou la fonction psychosociale. Des faits ré cents dé montrent qu'à la suite d'une lé sion nerveuse pé riphé rique, de nombreux patients ressentent de la douleur et souffrent d'une incapacité à long terme. Recommandation : Pour mieux comprendre la douleur né vropathique qui survient à la suite d'une lé sion nerveuse pé riphé rique, les prochaines é tudes devraient inclure des mesures valables et fiables des dé ficiences physiques, de la douleur, des incapacité s, de la qualité de vie lié e à la santé et à la fonctio...

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“…Painful end-neuromas in the hand and wrist have been divided into three zones (Fig 1) (Sood and Elliot, 1998). Zone I includes all true digital and dorsal innervating nerve injuries beyond the distal palmar crease.…”

Section: Introductionmentioning

confidence: 99%

Treatment of End-Neuromas, Neuromas-in-Continuity and Scarred Nerves of the Digits by Proximal Relocation

Hazari

Elliot

2004

Journal of Hand Surgery

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This paper reports the results of treatment by proximal relocation of 104 painful nerves in 57 digits in 48 patients. These included 86 digital nerves and 18 terminal branches of the superficial radial nerve and the dorsal branch of the ulnar nerve. Eighty-three were end-neuromas and 14 were neuromas-in-continuity, of which nine followed nerve repair and five occurred following a closed crush injury. Seven were painful as a result of tethering in scarred tissue. Eighty nerves (77%) required a single relocation and 24 (23%) required more than one operation. Ninety-eight per cent of nerve relocations achieved complete pain relief at the primary site. One patient had mild pain on pressure at the primary site after relocation of two nerves from this site. Over 90% of the nerves had no spontaneous pain, pain on movement or hypersensitivity of the overlying skin at the final site of relocation. However, the incidence of mild or no pain on direct pressure at the site of nerve relocation was lower at 83% as relocated nerves, although traumatized less often at the sites chosen for relocation, can still be painful on direct pressure.

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Treatment of Painful Neuromas of the Hand and Wrist by Relocation into the Pronator Quadratus Muscle

Cited by 65 publications

References 14 publications

Influence of human skin injury on regeneration of sensory neurons

Influence of human skin injury on regeneration of sensory neurons

Neuropathic Pain in Patients with Upper-Extremity Nerve Injury

Treatment of End-Neuromas, Neuromas-in-Continuity and Scarred Nerves of the Digits by Proximal Relocation

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