ABSTRACT
OBJECTIVES: The purpose of this retrospective study was to report the results of surgery in painful post-traumatic neuromas of the digital nerves treated by collagen conduits after excision of the neuromas, when two stumps were available. METHODS: We retrospectively reviewed all patients operated on for painful neuroma in our institution and having undergone repair with collagen conduits. Their files were retrieved by a coding file (CCAM version 10). Ten patients involving nine digital nerves and one common digital nerve were included. Primary outcome data points were static two-point discrimination, Semmes-Weinstein monofilament testing, Quick-Dash outcome survey scores, Cold Intolerance Symptom Severity (CISS) score and recurrence of pain at final follow-up. We set up a minimum follow-up period of 6 months after surgery. RESULTS: The patients' average age was 30 years. The average follow-up duration was 11.8 months. Five patients had excellent or good results (50%) at static two-point discrimination testing. Semmes-Weinstein monofilament testing results were full, diminished light touch or diminished protective sensation in nine digits (80%). The average Quick-Dash survey score was 19.3. The average CISS score was 27.8. There was no recurrence of pain. CONCLUSIONS: Our findings indicate that collagen conduit is an effective treatment for post-traumatic painful neuromas of digital nerves and common digital nerves.
Subject(s)
Amputation Stumps , Collagen , Fingers/innervation , Neoplasms, Post-Traumatic/therapy , Nerve Regeneration , Neuroma/therapy , Peripheral Nervous System Neoplasms/therapy , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasms, Post-Traumatic/diagnosis , Neuroma/diagnosis , Pain Measurement , Peripheral Nervous System Neoplasms/diagnosis , Postoperative Care/methods , Retrospective Studies , Sensation/drug effects , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVE: This study was to evaluate the current pattern and risk factors of Marjolin's ulcer in the authors' setting. SETTINGS AND PARTICIPANTS: Twenty-one patients with histological diagnosis of skin malignancy at the University of Calabar Teaching Hospital, Calabar, Nigeria. METHODS: Presented are patients with histologic diagnosis of Marjolin's seen in the University of Calabar Teaching Hospital, Calabar, Nigeria from January 2007 through December 2007. RESULTS: Five patients (3 men and 2 women) with Marjolin's ulcer whose ages ranged from 32 to 70 years (mean 46.6 years) accounted for 45.5% of squamous cell carcinoma. All the patients suffered traumatic injuries (4 lower limb injuries from road traffic accidents and 1 puncture wound of the upper limb) and the latency was 21.4 years. CONCLUSIONS: Chronic trauma-induced limb ulceration is the leading risk factor for Marjolin's ulcer. Health education, early detection, and proper management of chronic wounds would improve outcome.
