Abstract
The restoration of nerve function after the injury might be complicated by the development of a disorganized fibrous mass – a neuroma. This results in sensory and/or motor deficits and pain that can be severely debilitating. Surgical excision of the painful neuroma may leave a gap which can be bridged using autografts or allografts. The main objectives of this study were to obtain 1-year clinical results in patients where a painful neuroma in continuity was excised and reconstruction was done using decellularized allografts after nerve lesions in the upper extremity.In a prospective cohort study, we evaluated 21 consecutive patients. The patients were evaluated for pain, motor and sensory function of the hand, as well as with patient-reported outcomes.The results showed meaningful sensory recovery in 47% (≥S3), persisting cold intolerance in 48%, disabling hypersensitivity in 48%, and new neuroma formation proximal to or within the allograft in 25% of patients, one year postoperatively. Q-DASH showed 52% of patients with poor results. 43% of the patients had persisting pain in rest and activity. Measuring muscle strength showed grip strength of 60% and a pinch of 58% of the strength measured in the uninjured hand, which was statistically significant.Even with the excision of a neuroma in continuity and reconstruction with human acellular nerve allograft, limited functional outcome, pain, cold intolerance and hyperesthesia may persist in the treated patients. There is also the risk of new neuroma formation proximal to or within the allograft.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call