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January 8, 1982

Postoperative Compressive Neuropathies-Reply

JAMA. 1982;247(2):175. doi:10.1001/jama.1982.03320270015009

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In Reply.—  The author's comments regarding a surgical intervention as treatment for postoperative, compressive neuropathies are well taken. In the time interval since our work was originally submitted, we have tried to follow a more aggressive treatment plan at the urging of our surgeons. They recommend surgical decompression, or transposition, of the ulnar nerve within the first ten days after the onset of appropriate clinical symptoms and signs. They find less scar formation and think that the surgical results are better than if they undertook surgical treatment at a later date.Dr Belber thinks that the focal thickening of the epineurium, presumably at the site of compression, antedates the compressive injury and contributes to its clinical manifestation. However, as the function of the epineurium is protective and supportive of the enclosed nerve fibers, it may be that the author's "neuroma in continuity" is nothing more than the normal thickening of