Comparative analysis of curative effect of different surgeries for painful digital proper neuroma

Abstract

This paper aims to investigate the curative effect of different surgeries for painful digital proper neuroma. There were 30 patients with painful digital proper neuroma, among whom 11 patients underwent arched double end-to-side neuroanastomosis, 10 patients underwent nerve graft with end-to-end neuroanastomosis, while other 9 patients underwent directly end-to-end neuroanastomosis. The results showed that the two-point discrimination (2-PD) was (5.01 ± 0.71) mm in arched double end- to-side neuroanastomosis, which was significantly lower than that in nerve graft with end-to-end neuroanastomosis [(7.30 ± 1.21) mm] and directly end-to-end neuroanastomosis [(6.10 ± 1.10) mm; F = 3.144, P = 0.022]. According to Burchiel's efficacy, there were 9 excellent and 2 good fingers in arched double end-to-side neuroanastomosis; 4 excellent, 3 good and 3 fair fingers in nerve graft with end-to-end neuroanastomosis; 4 excellent, 4 good and one fair fingers in directly end-to-end neuroanastomosis. The efficacy of the first group was significantly better than those of the other 2 groups (Z = -1.927, P = 0.041). The arched nerves of double end-to-side neuroanastomosis is a valuable surgical method for painful digital proper neuroma, which can quickly restore the sensation of fingers, and have better outcome than the other two methods.

doi: 10.3969/j.issn.1672-6731.2014.09.014