"Targeted Muscle Reinnervation for treatment of post-resection Interdigital Neuroma: A Cadaveric Feasibility Study".

MedStar author(s):
Citation: Plastic & Reconstructive Surgery. 2022 Oct 11PMID: 36219864Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:
  • 0032-1052
Name of journal: Plastic and reconstructive surgeryAbstract: BACKGROUND: Symptomatic, post-resection interdigital neuroma is a frustrating problem that causes debilitating foot pain. Implementing the concepts of targeted muscle innervation (TMR), this study offers a novel nerve transfer involving the resected third common plantar digital nerve (CPDN) to the motor nerve branch of the third dorsal interosseous muscle (DIMB) to improve post-resection pain.CONCLUSION: Given their anatomical locations, a nerve transfer between the third CPDN and third DIMB is surgically feasible. This novel technique is a viable option which can be used instead of the conventional technique of muscle implantation or more proximal re-resection for symptomatic post-resection interdigital neuroma. Copyright © 2022 by the American Society of Plastic Surgeons.METHODS: Ten fresh feet from seven cadaveric donors were used for this study. CPDN and DIMB lengths and diameters were measured, along with nerve overlap after the transfer with ankle in neutral position and in maximal dorsiflexion. Motor entry point (MEP) to the calcaneal tuberosity and to the fifth metatarsal tuberosity were measured and used to evaluate the ratio relative to foot length. Means, standard deviations, and p-values were calculated for each parameter and between gender (male and female) and feet (right and left).RESULTS: In all specimens, the nerve transfer was technically feasible, without notable size mismatch between the donor and recipient nerves. CPDN, DIMB, and important anatomical reference points were identifiable in all specimens. Average CPDN length was 30.1+/-8.2 mm. The average DIMB length was 14.4+/-3.9 mm. The overlap between the donor and recipient in neutral ankle position at the transfer site was 6.4+/-1.8mm.All authors: Giladi AM, Melamed E, Shubinets V, Titanji BNFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2022-10-27
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Journal Article MedStar Authors Catalog Article 36219864 Available 36219864

BACKGROUND: Symptomatic, post-resection interdigital neuroma is a frustrating problem that causes debilitating foot pain. Implementing the concepts of targeted muscle innervation (TMR), this study offers a novel nerve transfer involving the resected third common plantar digital nerve (CPDN) to the motor nerve branch of the third dorsal interosseous muscle (DIMB) to improve post-resection pain.

CONCLUSION: Given their anatomical locations, a nerve transfer between the third CPDN and third DIMB is surgically feasible. This novel technique is a viable option which can be used instead of the conventional technique of muscle implantation or more proximal re-resection for symptomatic post-resection interdigital neuroma. Copyright © 2022 by the American Society of Plastic Surgeons.

METHODS: Ten fresh feet from seven cadaveric donors were used for this study. CPDN and DIMB lengths and diameters were measured, along with nerve overlap after the transfer with ankle in neutral position and in maximal dorsiflexion. Motor entry point (MEP) to the calcaneal tuberosity and to the fifth metatarsal tuberosity were measured and used to evaluate the ratio relative to foot length. Means, standard deviations, and p-values were calculated for each parameter and between gender (male and female) and feet (right and left).

RESULTS: In all specimens, the nerve transfer was technically feasible, without notable size mismatch between the donor and recipient nerves. CPDN, DIMB, and important anatomical reference points were identifiable in all specimens. Average CPDN length was 30.1+/-8.2 mm. The average DIMB length was 14.4+/-3.9 mm. The overlap between the donor and recipient in neutral ankle position at the transfer site was 6.4+/-1.8mm.

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