caa a22 4500 606216731 CHVBK 20210128101104.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2561-y doi (NATIONALLICENCE)springer-10.1007/s00701-015-2561-y A simple method of skin mapping for planning the operative approach in peripheral nerve injuries [Elektronische Daten] [Panagiotis Symeonidis, Nikolaos Daniilidis, Panagiotis Givissis] Background: The operative treatment of post-traumatic neuromas includes open exploration, excision of adhesions and/or neurectomy. Apart from the anatomical variations of the peripheral nerves and their branches' routes, nerves may be further deviated from their expected anatomical locations due to scar tissue formation. We describe a simple and reproducible method of preoperative skin marking which aids the development of an accurate surgical exposure for the localisation of a lesion. Method: Skin marking is based on clinical assessment and is performed by the bedside on the day of the operation. It consists of mapping the skin with permanent marker by repeatedly using three symbols, namely √, O or X. These refer respectively to areas of normal sensation, numbness (decreased or no sensation without paraesthesia) and pain/dysaesthesia. Points with a positive Tinel sign were marked with an "X in a square”. Fourteen patients, aged 21-55years old, with post-traumatic neuromas, were marked with the method. A total of 18 neuromas were successfully located in the upper and lower limbs. Results: In all cases the preoperative skin marking corresponded to the course of the nerve and/or its branches. All patients were improved with a good to excellent clinical outcome. Conclusions: Planning the surgical approach according to the skin marking enabled limited operative exposures and corresponded to atypical locations and branching of the peripheral nerves. Springer-Verlag Wien, 2015 Skin mapping nationallicence Neuroma nationallicence Post-traumatic nationallicence War injury nationallicence Surgical approach nationallicence Symeonidis Panagiotis Aristotelian University of Thessaloniki, E.Amynis 18, TK 54621, Thessaloniki, Greece aut Daniilidis Nikolaos Interbalkan European Medical Center, Mitropoleos 46-48, TK 54623, Thessaloniki, Greece aut Givissis Panagiotis Aristotelian University of Thessaloniki, Egnatia 142, TK 54622, Thessaloniki, Greece aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1953-1958 0001-6268 157:11<1953 2015 157 701 https://doi.org/10.1007/s00701-015-2561-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2561-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Symeonidis Panagiotis Aristotelian University of Thessaloniki, E.Amynis 18, TK 54621, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Daniilidis Nikolaos Interbalkan European Medical Center, Mitropoleos 46-48, TK 54623, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Givissis Panagiotis Aristotelian University of Thessaloniki, Egnatia 142, TK 54622, Thessaloniki, Greece aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1953-1958 0001-6268 157:11<1953 2015 157 701