Michael P Gaspar1, Patrick M Kane1, Michael M Vosbikian2,3, Constantinos Ketonis2, Mark S Rekant1. 1. * Department of Orthopaedic Surgery, The Philadelphia Hand Center, P.C., Thomas Jefferson University, USA. 2. † Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, Philadelphia, PA. 3. ‡ Department of Orthopaedics, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA.
Abstract
BACKGROUND: Entrapment of the superficial sensory branch of the radial nerve (SRN) commonly results in debilitating pain of the dorsoradial wrist. Symptom relief following SRN neurolysis is often incomplete or temporary due to recurrent perineural scarring. METHODS: We performed a retrospective review with prospective follow-up of all patients with SRN neuropathy who were treated with neurolysis and nerve wrapping using an amnion-based allograft adhesion barrier over a one-year interval. Measured outcomes included pain rated by Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) functional outcome scores. RESULTS: Three females satisfied inclusion. At mean follow-up of 28.9 months, all three patients exhibited improved pain (mean VAS change -4.7 ± 0.6), function (mean QuickDASH change -40 ± 5), and subjective satisfaction. No adverse events or reactions to the implanted tissue occurred. CONCLUSIONS: SRN entrapment neuropathy was safely and effectively treated with neurolysis and amnion nerve wrapping in this small series. Use of this technique for perineural scar prevention warrants additional study in larger groups of patients and in other upper extremity entrapment neuropathies.
BACKGROUND: Entrapment of the superficial sensory branch of the radial nerve (SRN) commonly results in debilitating pain of the dorsoradial wrist. Symptom relief following SRN neurolysis is often incomplete or temporary due to recurrent perineural scarring. METHODS: We performed a retrospective review with prospective follow-up of all patients with SRN neuropathy who were treated with neurolysis and nerve wrapping using an amnion-based allograft adhesion barrier over a one-year interval. Measured outcomes included pain rated by Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) functional outcome scores. RESULTS: Three females satisfied inclusion. At mean follow-up of 28.9 months, all three patients exhibited improved pain (mean VAS change -4.7 ± 0.6), function (mean QuickDASH change -40 ± 5), and subjective satisfaction. No adverse events or reactions to the implanted tissue occurred. CONCLUSIONS: SRN entrapment neuropathy was safely and effectively treated with neurolysis and amnion nerve wrapping in this small series. Use of this technique for perineural scar prevention warrants additional study in larger groups of patients and in other upper extremity entrapment neuropathies.
Entities:
Keywords:
Allograft nerve wrapping; Amniotic membrane adhesion barrier; Neurolysis; Recurrent neuropathy; Superficial sensory branch of the radial nerve; Wartenberg syndrome
Authors: Hailey P Huddleston; Neil V Shah; Joey S Kurtzman; Qurratul-Ain Dar; Hanbin Wang; John Carter; Westley T Hayes; Alba Avoricani; Karan Dua; Steven M Koehler Journal: Plast Reconstr Surg Glob Open Date: 2021-11-11