Outcomes Following Isolated Posterior Interosseous Nerve Neurectomy: A Systematic Review.

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Pain Management

Background:

• Chronic dorsal wrist pain is often treated with posterior interosseous nerve neurectomies (PINN).
• Existing literature on PINN primarily comprises small case series, often as an adjunct procedure, limiting understanding of isolated PINN outcomes.
• A systematic review was conducted to characterize outcomes of isolated PINN.

Purpose of the Study:

• To systematically review and characterize patient outcomes following isolated posterior interosseous nerve neurectomies.
• To evaluate return to work, patient satisfaction, pain/function scores, range of motion, complications, and pain recurrence after PINN.

Main Methods:

• Systematic literature review of isolated posterior interosseous nerve neurectomies.
• Inclusion criteria: English-language papers from PubMed on isolated PINN; exclusion of procedures as adjunct treatment.
• Primary outcomes assessed: return to work, patient satisfaction, pain/function scores, wrist range of motion, complications, and pain recurrence.

Main Results:

• The review included 6 studies with 135 patients (136 cases); average age 43.6 years, 54.1% female.
• At an average 51-month follow-up, 88.9% returned to work, and 88.4% reported subjective improvement and satisfaction.
• Pain recurrence occurred in 25.5% at 12.3 months; complication rate (excluding recurrence) was 0.9%.

Conclusions:

• Isolated posterior interosseous nerve neurectomies demonstrate excellent clinical outcomes for chronic dorsal wrist pain.
• A significant majority of patients experience sustained relief and satisfaction post-procedure.
• While effective, a notable percentage of patients may experience pain recurrence, necessitating long-term monitoring.