To the Editor.—
The development of postoperative compressive neuropathies—ulnar, radial, and peroneal—in our series was related not only to prolonged compression of several hours, but also, in every instance, to a chronic, dense neuroma in continuity. There is no doubt that the short-term compression was the proximate cause of the neuropathy but, from the operative evidence, the preexisting chronic neuroma would appear to be an essential cofactor; in other words, an already partly anatomically compromised—but fully functional— nerve was pushed "over the edge" by a compressive stress, causing an acute neuropathy.Therefore, in contrast to the outlook promoted by John F. Aita, MD (1981;245:2295), stating that these patients have a "poor prognosis... whether treated medically or surgically with transposition or decompression" and suggesting that treatment is "limited to counseling the patient," I would urge physicians to look at this lesion in a more positive way.In my experience, during a
Belber CJ. Postoperative Compressive Neuropathies. JAMA. 1982;247(2):175. doi:10.1001/jama.1982.03320270015008
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