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Reset Neurectomy for Cutaneous Nerve Injuries.

Kyle R Eberlin1, Brent B Pickrell1, Ryoko Hamaguchi2

  • 1Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Plastic and Reconstructive Surgery. Global Open
|March 8, 2021
PubMed
Summary
This summary is machine-generated.

Diffuse nerve injuries from crush trauma present surgical challenges. A "reset neurectomy" technique, involving proximal neurectomy and immediate repair, offers a potential solution for neuropathic pain.

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Area of Science:

  • Neurosurgery
  • Peripheral Nerve Surgery
  • Pain Management

Background:

  • Diffuse cutaneous nerve injuries, often from crush mechanisms, pose significant challenges for nerve surgeons.
  • Unlike discrete nerve transections, these injuries lack a clear treatment algorithm.
  • Neuropathic pain is a primary symptom in many diffuse nerve injury cases.

Purpose of the Study:

  • To describe a novel surgical technique,
  • reset neurectomy
  • , for managing diffuse, nontransection nerve injuries.
  • To evaluate the utility of local anesthetic blocks in determining surgical candidacy for these injuries.
  • To present a potential treatment strategy for neuropathic pain stemming from diffuse nerve damage.

Main Methods:

  • A
  • reset neurectomy
  • technique is described, involving neurectomy proximal to the injury zone.
  • Immediate nerve repair or reconstruction, potentially with nerve grafting, follows the neurectomy.
  • Pre-operative local anesthetic blocks proximal to the injury were used to assess surgical potential.

Main Results:

  • The
  • reset neurectomy
  • technique was applied to cases of diffuse, nontransection nerve injuries.
  • Successful local anesthetic blocks indicated potential for surgical intervention.
  • The technique aims to alleviate neuropathic pain as the primary symptom.

Conclusions:

  • The
  • reset neurectomy
  • technique offers a viable surgical option for diffuse cutaneous nerve injuries.
  • This method may effectively manage neuropathic pain when it is the predominant symptom.
  • Local anesthetic blocks can aid in selecting patients for this surgical approach.