Peripheral nerve tumours: A 66-case retrospective study. / Tumores de los nervios periféricos: estudio retrospectivo de 66 casos.

BACKGROUND/OBJECTIVES: Peripheral nerve tumours (PNT) are rare lesions that are generally categorised as soft tissue tumours, so they are usually managed by a range of surgical disciplines such as plastic, orthopaedic and trauma surgery, dermatology, general surgery and neurosurgery. Appropriate knowledge of the therapeutic indication and surgical management are essential in order to avoid neurological deficit. MATERIALS AND METHODS: This is a retrospective study of 66 tumour lesions in 64 patients, acquired from the joint experience of 2surgical teams specialised in peripheral nerve surgery. RESULTS: The most common location was the lower limb and upper limb with 48 tumour lesions. The most common pathological diagnosis was Schwannoma, accounting for 51.5%. Complete tumour resection was achieved in 81.8% of the lesions and always with neurophysiological stimulation and/or monitoring. The most common postsurgical complication was neuropathic pain and/or a transient sensory disorder in 15% of surgeries, with only one persistent motor deficit appearing in 2cases that required nerve graft reconstruction. CONCLUSIONS: Although the therapeutic management of benign tumours such as Schwannomas can be considered to be relatively simple thanks to the application of the basic concepts of peripheral nerve microsurgery, malignant tumors, despite being very rare, require multidisciplinary management. The option of pre-surgical biopsy remains a controversial issue and no consensus has been reached among the different authors. In our opinion, percutaneous biopsy is not necessary in most cases.

Treatment of proximal interphalangeal joint flexion contracture: combined static and dynamic orthotic intervention compared with other therapy intervention: a randomized controlled trial.

PURPOSE: To test the effectiveness of static and dynamic orthoses using them as an exclusive treatment for proximal interphalangeal (PIP) joint flexion contracture compared with other hand therapy conservative treatments described in the literature. METHODS: 60 patients who used orthoses were compared with a control group that received other hand therapy treatments. Clinical assessments were measured before the experiment and 3 months after and included active PIP joint extension and function. RESULTS: A significant improvement in the extension active range of motion at the PIP joint in the second measurement was found in both groups, but it was significantly greater in the experimental group. Improvement in function (Disabilities of the Arm, Shoulder, and Hand score) between the first and second assessment was similar in the control and experimental groups. CONCLUSIONS: Using night progressive static and daily dynamic orthoses as an exclusive treatment during the proliferative phase led to significant improvements in the PIP joint active extension, but the improvement did not correlate with increased function as perceived by the patient. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.