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Erschienen in: HAND 2/2006

01.12.2006 | Original Paper

Anterior and Posterior Interosseous Neurectomy for the Treatment of Chronic Dynamic Instability of the Wrist

verfasst von: Eric P. Hofmeister, Steven L. Moran, Alexander Y. Shin

Erschienen in: HAND | Ausgabe 2/2006

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Abstract

The purpose of this study was to determine the results of combined anterior and posterior interosseous neurectomy (AIN/PIN) in patients with chronic wrist pain secondary to dynamic instability, and to determine the predictability of selective AIN/PIN blocks with respect to pain relief, grip strength, and outcome of the neurectomy. A prospectively accrued chronic wrist pain registry was undertaken. Inclusion criteria were patients with arthroscopically confirmed dynamic wrist instability who had undergone a diagnostic AIN/PIN injection, followed by a single dorsal incision neurectomy. All patients completed Disabilities of the Arm, Shoulder and Hand outcome questionnaires preoperatively and at intervals postoperatively. Pre- and postoperative range of motion, grip strength, and percentage pain relief were recorded. Over a 3-year period, 50 wrists (48 patients) were enrolled: average follow-up was 28 months (range: 24–42 months). The average improvement in grip strength after denervation was 16% (p = 0.076), the average improvement in subjective pain rating was 51% (p < 0.0001), and the average improvement in Disabilities of the Arm, Shoulder, and Hand scores was 15 points (p = 0.0039). Improvement of pain from diagnostic injections was not predictive of final improvement of pain; however, improvement in grip strength after diagnostic injections did correlate with improved grip strength after surgery. Lack of improvement in subjective pain rating or grip strength after diagnostic injection approached statistical significance. There was no decrease in range of motion postoperatively. Fourteen patients (16 wrists) failed as defined by need for subsequent surgery. The results of AIN/PIN neurectomy demonstrate that it may be an effective alternative to wrist salvage or reconstructive procedures within the first few years of follow-up.
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Metadaten
Titel
Anterior and Posterior Interosseous Neurectomy for the Treatment of Chronic Dynamic Instability of the Wrist
verfasst von
Eric P. Hofmeister
Steven L. Moran
Alexander Y. Shin
Publikationsdatum
01.12.2006
Verlag
Springer-Verlag
Erschienen in
HAND / Ausgabe 2/2006
Print ISSN: 1558-9447
Elektronische ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-006-9003-5

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