Surgically Treated Neuroma in Upper Extremity : Patient Characteristics and Factors Influencing Outcome of Surgery
(2022) In Plastic and Reconstructive Surgery - Global Open 10(1). p.4076-4076- Abstract
Background: Neuroma formation occurs after inappropriately or untreated nerve injuries. Patients surgically treated for neuroma were characterized and factors influencing outcome evaluated. Methods: In a retrospective observational study, data from medical records of patients surgically treated for neuroma in two Swedish regions were analyzed. Results: In 115 included patients (median age at surgery 45 years [IQR 29-55]), 55% (62/115) were men and 49% (56/115) were manual laborers. Most affected nerves were in hand or lower forearm (76/115, 66%). Smoking habits, affected nerves, and cause/mechanism(s) of injury differentiated the sexes. More motor nerve injuries were observed among women and more mixed nerve injuries among men.... (More)
Background: Neuroma formation occurs after inappropriately or untreated nerve injuries. Patients surgically treated for neuroma were characterized and factors influencing outcome evaluated. Methods: In a retrospective observational study, data from medical records of patients surgically treated for neuroma in two Swedish regions were analyzed. Results: In 115 included patients (median age at surgery 45 years [IQR 29-55]), 55% (62/115) were men and 49% (56/115) were manual laborers. Most affected nerves were in hand or lower forearm (76/115, 66%). Smoking habits, affected nerves, and cause/mechanism(s) of injury differentiated the sexes. More motor nerve injuries were observed among women and more mixed nerve injuries among men. Iatrogenic injuries, such as injury to superficial sensory radial nerve or thenar branch of median nerve, more frequently affected women (27/52, 52%). Pain, the dominant preoperative symptom, improved after surgery. Overall, surgery cured/ improved 79 of 115 (69%) patients. Patients treated with repair or reconstruction (n = 62) were younger than patients given neuroma transpositions (n = 43) and sensory nerve injuries were more often treated by transposition. No difference in outcome was observed concerning patient characteristics or surgical methods. Most patients had one surgery (102/115, 89%). No specific risk factors for a re-operation could be identified, but need for re-operation(s) was associated with poor outcome, even after repeated surgery. Conclusions: Patients with a neuroma benefit from surgery with significantly reduced pain, but symptoms may remain. Surgical method does not affect outcome. Preventing neuroma formation is crucial, presently highlighted in a high frequency of iatrogenic injuries, especially among women.
(Less)
- author
- Nyman, Erika LU ; Dahlin, Emma LU ; Gudinge, Hanna and Dahlin, Lars B. LU
- organization
- publishing date
- 2022-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Plastic and Reconstructive Surgery - Global Open
- volume
- 10
- issue
- 1
- pages
- 4076 - 4076
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:35186631
- scopus:85124290665
- ISSN
- 2169-7574
- DOI
- 10.1097/GOX.0000000000004076
- language
- English
- LU publication?
- yes
- id
- 4f4bfa16-2373-4d1e-8a4b-99a04f51f037
- date added to LUP
- 2023-01-02 12:40:09
- date last changed
- 2024-09-06 21:51:41
@article{4f4bfa16-2373-4d1e-8a4b-99a04f51f037, abstract = {{<p>Background: Neuroma formation occurs after inappropriately or untreated nerve injuries. Patients surgically treated for neuroma were characterized and factors influencing outcome evaluated. Methods: In a retrospective observational study, data from medical records of patients surgically treated for neuroma in two Swedish regions were analyzed. Results: In 115 included patients (median age at surgery 45 years [IQR 29-55]), 55% (62/115) were men and 49% (56/115) were manual laborers. Most affected nerves were in hand or lower forearm (76/115, 66%). Smoking habits, affected nerves, and cause/mechanism(s) of injury differentiated the sexes. More motor nerve injuries were observed among women and more mixed nerve injuries among men. Iatrogenic injuries, such as injury to superficial sensory radial nerve or thenar branch of median nerve, more frequently affected women (27/52, 52%). Pain, the dominant preoperative symptom, improved after surgery. Overall, surgery cured/ improved 79 of 115 (69%) patients. Patients treated with repair or reconstruction (n = 62) were younger than patients given neuroma transpositions (n = 43) and sensory nerve injuries were more often treated by transposition. No difference in outcome was observed concerning patient characteristics or surgical methods. Most patients had one surgery (102/115, 89%). No specific risk factors for a re-operation could be identified, but need for re-operation(s) was associated with poor outcome, even after repeated surgery. Conclusions: Patients with a neuroma benefit from surgery with significantly reduced pain, but symptoms may remain. Surgical method does not affect outcome. Preventing neuroma formation is crucial, presently highlighted in a high frequency of iatrogenic injuries, especially among women.</p>}}, author = {{Nyman, Erika and Dahlin, Emma and Gudinge, Hanna and Dahlin, Lars B.}}, issn = {{2169-7574}}, language = {{eng}}, number = {{1}}, pages = {{4076--4076}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Plastic and Reconstructive Surgery - Global Open}}, title = {{Surgically Treated Neuroma in Upper Extremity : Patient Characteristics and Factors Influencing Outcome of Surgery}}, url = {{http://dx.doi.org/10.1097/GOX.0000000000004076}}, doi = {{10.1097/GOX.0000000000004076}}, volume = {{10}}, year = {{2022}}, }