Cold Intolerance in Surgically Treated Neuroma Patients: A Prospective Follow-Up Study

Stokvis, Annemieke; Ruijs, Aleid; Neck, Johan W. van; Coert, J. Henk

doi:10.1016/j.jhsa.2009.06.003

Cited by 28 publications

(13 citation statements)

References 40 publications

(40 reference statements)

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“…Pain may also be associated with cold sensitivity 15,27,28,[64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] . The present study showed that patients with peripheral nerve injury had high levels of cold sensitivity and disability and that disability was predicted by pain and cold sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…The present study showed that patients with peripheral nerve injury had high levels of cold sensitivity and disability and that disability was predicted by pain and cold sensitivity. Many studies have demonstrated persistent cold sensitivity and substantial pain following hand trauma 65,66,68,71,76,79 . Cold sensitivity remains a challenge following peripheral nerve injury, particularly for patients who reside in cold environments.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

Novak

Anastakis

Beaton

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

111

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

Novak

Anastakis

Beaton

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

111

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“…Second, there is no consensus as to which envelopment of the proximal stump is optimal. ( Fig 4 ) The proximal stump can be buried in bone[ 10 , 14 – 16 , 33 , 43 , 48 , 51 ], muscle,[ 9 , 10 , 12 , 14 – 16 , 18 , 21 – 29 , 33 , 35 , 41 , 46 – 48 , 51 , 52 , 60 , 66 ] vein[ 12 , 32 , 36 – 38 ] or nerve. [ 13 , 57 , 59 ] Local factors in the area of the damaged nerve play a role in neuropathic pain[ 69 ] and provocation might not be entirely a mechanical problem.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of a diagnostic block in focal nerve injury with neuropathic pain when surgery is considered

et al. 2018

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ObjectIn patients with focal nerve injury and neuropathic pain cutting the nerve to obtain permanent pain reduction can be considered. Surgery is indicated only if a diagnostic nerve block provides temporary pain relief. We evaluated the predictive value of a block on the outcome of surgery.MethodsIn total, three blocks were performed at two week intervals. Patients were blinded to injections containing lidocaine 1% and a placebo was included. Surgery was offered regardless of the effect of the blocks. Twenty-four patients received 72 blocks. Sixteen patients opted for surgery, 5 patients refrained from surgery, and in 3 the blocks provided permanent pain relief. The predictive ability of the block on the outcome of surgery was assessed by calculating the area under a Receiver Operating Characteristic curve (AUC).ResultsThe AUC of the first lidocaine block was 0.35 with a 95% confidence interval from 0.077 to 0.62. At 95% confidence (two-sided), the AUC is less than 0.62, and hence the predictive ability of the block was poor. The outcome of the second lidocaine block and saline block did not change the conclusion of the first block.ConclusionsWe conclude that the use of blocks to select patients for surgery should be critically appraised.PerspectiveA pain relieving response to one open block is currently considered mandatory before patients with focal nerve injury and neuropathic pain are offered surgery. Blinded blocks including a placebo show that responses for selection should be carefully interpreted because they may not be as predictive as generally presumed.

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“…Most symptomatic neuromas involve pain, dysesthesia, hypesthesia, paresthesia, cold intolerance, and most commonly have a Tinel sign at the neuroma site. 5 , 6 …”

Section: Diagnosis and Initial Approachmentioning

confidence: 99%

“…Symptoms of a neuroma include pain (usually sharp or burning), paresthesias, numbness, cold intolerance, and electrical sensitivity, among others. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Surgical Algorithm for Neuroma Management: A Changing Treatment Paradigm

Eberlin

Dučić²

2018

Plastic and Reconstructive Surgery - Global Open

144

157

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Successful treatment of the painful neuroma is a particular challenge to the nerve surgeon. Historically, symptomatic neuromas have primarily been treated with excision and implantation techniques, which are inherently passive and do not address the terminal end of the nerve. Over the past decade, the surgical management of neuromas has undergone a paradigm shift synchronous with the development of contemporary techniques aiming to satisfy the nerve end. In this article, we describe the important features of surgical treatment, including the approach to diagnosis with consideration of neuroma type and the decision of partial versus complete neuroma excision. A comprehensive list of the available surgical techniques for management following neuroma excision is presented, the choice of which is often predicated upon the availability of the terminal nerve end for reconstruction. Techniques for neuroma reconstruction in the presence of an intact terminal nerve end include hollow tube reconstruction and auto- or allograft nerve reconstruction. Techniques for neuroma management in the absence of an intact or identifiable terminal nerve end include submuscular or interosseous implantation, centro-central neurorrhaphy, relocation nerve grafting, nerve cap placement, use of regenerative peripheral nerve interface, “end-to-side” neurorrhaphy, and targeted muscle reinnervation. These techniques can be further categorized into passive/ablative and active/reconstructive modalities. The nerve surgeon must be aware of available treatment options and should carefully choose the most appropriate intervention for each patient. Comparative studies are lacking and will be necessary in the future to determine the relative effectiveness of each technique.

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Cold Intolerance in Surgically Treated Neuroma Patients: A Prospective Follow-Up Study

Cited by 28 publications

References 40 publications

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

Predictive value of a diagnostic block in focal nerve injury with neuropathic pain when surgery is considered

Surgical Algorithm for Neuroma Management: A Changing Treatment Paradigm

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