Artikel
Are surgical interventions of isolated lesions of the superficial radial nerve promising?
Ist ein chirurgisches Vorgehen bei isolierten Läsionen des Ramus superficialis N.radialis erfolgversprechend?
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Lesions of the radial sensory nerve causes alteration of function of its nerve fibers, resulting in symptoms of numbness and tingling or burning and pain over the dorsoradial aspect of the forearm, wrist and hand. The aim of this study is to find out which surgical technique is indicated for lesions of this nerve.
Methods
In a retrospective study, 22 patients with lesion of the superficial branch of the radial nerve were treated surgically in the last ten years in our neurosurgical department. The patients' main complaints were burning pain and paraesthesia. Six patients had previously undergone a tendolysis because of tendovaginitis stenosans de Quervain.
In 8 nerve lesions, the continuity could be maintained and so the surgical procedure was restricted to an external neurolysis. In 4 cases the nerve was reconstructed after resection of the neuroma (end-to-end-suture or use of a vicryl-conduit) and in 10 cases the neuroma was resected and a transposition of the proximal nerve end was performed.
Results
19 patients could be evaluated with an average follow-up of 51 months. Surprisingly, in only 5 cases was pain relief achieved after surgery. 7 patients showed an unchanged postoperative status, in one case pain was even worse after the surgical intervention. Satisfying results (pain relief or pain reduction in 75%) could only be found among the patients in whom the neuroma was resected and the proximal nerve end was transposed in the muscle.
Conclusions
Surgical interventions for isolated lesions of superficial radial nerve must be weighed very carefully because of a limited prospect of success. Furthermore, a nerve reconstruction is not desirable in our opinion.