Purpose: Traumatic crush injuries of the lower limb often accompany severe complications. The incorporation of hyperbaric oxygen therapy to standard trauma care may have the potential to diminish injury-related complications and improve outcome in such cases. This systematic review aims to evaluate the effectiveness of hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries. Methods: The electronic databases Medline, Embase and Cochrane Library were searched to identify studies involving patients with crush-associated sever lower limb soft tissue injuries who received hyperbaric oxygen therapy in conjunction with standard trauma care. Relevant data on type of injury, hyperbaric oxygen therapy protocol and outcome related to wound healing were extracted. Results: In total seven studies met the inclusion criteria, involving 229 patients. The studies included two randomized clinical trials, one retrospective cohort study, three case series and one case report. The randomized placebo-controlled clinical trial showed a significant increase in wound healing and decrease in the need for additional surgical interventions in the patient group receiving hyperbaric oxygen therapy when compared to those undergoing sham therapy. The randomized non-placebo-controlled clinical trial revealed that early hyperbaric oxygen therapy reduces tissue necrosis and the likelihood of long-term complications. The retrospective cohort study indicated that hyperbaric oxygen therapy effectively reduces infection rates and the need for additional surgical interventions. The case series and case report presented beneficial results with regard to wound healing when hyperbaric oxygen therapy was added to the treatment regimen. Conclusion: Hyperbaric oxygen therapy is generally considered a safe therapeutic intervention and seems to have a beneficial effect on wound healing in severe lower limb soft tissue injuries when implemented as an addition to standard trauma care.

Background/Objectives: Neuropathic chronic postherniorrhaphy inguinal pain (CPIP) is a serious adverse outcome following inguinal hernia repair surgery. The optimal surgical treatment for neuropathic CPIP remains controversial in the current literature. This systematic review aims to evaluate the effectiveness of various surgical techniques utilized to manage neuropathic CPIP. Methods: The electronic databases Medline, Embase, Web of Science, Cochrane Central, and Google Scholar were searched. Inclusion criteria were defined to select studies reporting on the efficacy of surgical interventions in patients with neuropathic CPIP. The primary outcome was postoperative pain relief, as determined by postoperative numerical or nonnumerical pain scores. Results: Ten studies met the inclusion criteria. Three surgical techniques were identified: selective neurectomy, triple neurectomy, and targeted muscle reinnervation. Proportions of good postoperative results of the surgical techniques ranged between 46 and 88 percent. Overall, the surgical treatment of neuropathic CPIP achieved a good postoperative result in 68 percent (95% CI, 49 to 82%) of neuropathic CPIP patients (n = 244), with targeted muscle reinnervation yielding the highest proportion of good postoperative results. Conclusions: The surgical treatment of neuropathic CPIP is generally considered safe and has demonstrated effective pain relief across various surgical techniques. Targeted muscle reinnervation exhibits considerable potential for surpassing current success rates in inguinal hernia repair surgery.

Chronic pain after breast cancer surgery, affecting 25%-60% of patients, significantly impacts the survivors' quality of life. With improved survival rates, more individuals are experiencing this long-term complication. It is often overlooked that this chronic pain may stem from peripheral nerve injury, resulting in neuropathic pain characterized by burning sensations, electric shocks, and heightened sensitivity. Although neuropathic pain prevalence is reported at 24%-36% post-mastectomy, the data following breast-conserving surgery remain limited. This systematic review aimed to investigate the prevalence of neuropathic pain after breast-conserving surgery and its potential association with axillary procedures. The electronic databases, Medline, Embase, Web of Science and Cochrane Central, were searched. Inclusion criteria were defined to include studies reporting on the prevalence of neuropathic pain following breast-conserving surgery and exploring associations with axillary procedures. A meta-analysis was performed to compute a pooled prevalence rate. Eight studies, covering 1,469 patients post-breast-conserving surgery, met the inclusion criteria. The meta-analysis revealed a pooled prevalence of 31% (95% confidence intervals [CI] 0.14-0.56) neuropathic pain among patients who underwent breast-conserving surgery. Six studies explored associations with axillary procedures; however, none suggested a correlation between axillary procedures and neuropathic pain after breast-conserving surgery. This systematic review and meta-analysis indicated a pooled prevalence of 31% neuropathic pain following breast-conserving surgery of, with confidence interval ranging from 14% to 56%. The review did not provide conclusive evidence to suggest correlations between axillary procedures and neuropathic pain after breast-conserving surgery.

Introduction: Traditional surgical treatments for wrist osteoarthritis, such as arthrodesis or arthroplasty, are invasive and irreversibly compromise joint motion. Wrist denervation offers a less invasive alternative aimed at pain relief while preserving mobility. However, its durability remains uncertain. The aim of the study is to evaluate whether wrist denervation prevents further osteoarthritis-related wrist surgery in the mid- to long-term. Methods: This prospective multicentre study included patients with symptomatic wrist osteoarthritis who underwent wrist denervation after failed non-surgical treatment between 2012 and 2024, with a minimum follow-up of 12 months. The primary outcome was procedure success, defined as the proportion of wrists not requiring further osteoarthritis-related surgery. Secondary outcomes included visual analogue scale (0–100) scores for pain and function, patient satisfaction and willingness to repeat the procedure. Results: One hundred and twelve patients (114 wrists) were included. At a median follow-up of 4 years (1–13), 86% of wrists did not undergo further osteoarthritis-related surgery after denervation. Most reoperations occurred within 2 years. Mean visual analogue scale pain score at rest significantly improved from 48 (SD 28) preoperatively to 26 (SD 29) (reduction: 22 points). Mean visual analogue scale function significantly improved from 55 (SD 26) to 69 (SD 24) (improvement: 14 points). Patient satisfaction was rated as good or excellent in 60%, and 82% were willing to undergo the same treatment again. Conclusion: Wrist denervation yields durable symptom relief and can, in many cases (86%), prevent further osteoarthritis-related surgery in patients with wrist osteoarthritis over a median 4 year follow-up. Level of Evidence: II