神经断端肌肉内埋入法治疗汶川地震截肢伤员痛性神经瘤

Treatment of painful stump neuroma by resection and nerve stump implantation into muscle in twelve Wenchuan earthquake amputees

目的探讨神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤的临床疗效。方法应用神经断端肌肉内埋入法治疗汶川地震伤截肢伤员痛性神经瘤12例27处,观察术后症状、体征及患肢功能改变情况。结果 12例全部获随访12～26个月,平均16个月。随访时患者主诉肢体残端疼痛和触电感消失;局部无压痛、叩击痛和Tinel征,残端软组织内未触及硬性结节或包块;患肢功能较术前明显改善。结论 采用神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤,可减轻痛苦,疗效确切。

Objective To investigate the clinical efficacy of a painful stump neuroma treatment by resection and nerve stump implantation into muscle in treating Wenchuan earthquake amputees. Methods In 12 Wenchuan earthquake amputees （27 painful neuromas）, painful neuroma underwent resection and implantation into the nearby muscle. Changes of symptoms and limb function were observed. Results All the cases were followed up for 12 - 26 months with an average of 16 months. It was shown that limb stump pain and ＂electric - shock＂ sensation disappeared without any local tenderness, percussion tenderness or Tinel sign. The soft tissue nodule or mass of limb stump disappeared. Limb function improved, compared with preoperative evaluation. Conclusions Resection and nerve stump implantation into muscle is a feasible and effective method for treatment of painful stump neuroma after amputation.