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Journal of Bone and Joint Surgery - British Volume, Vol 71-B, Issue 3, 379-382
Copyright © 1989 by British Editorial Society of Bone and Joint Surgery

Articles

A new operation for the prevention and treatment of amputation neuromas

A Martini and B Fromm

Department of Hand Surgery, Orthopaedic University Hospital, Heidelberg, West Germany.

A stump neuroma is caused by the disorganised growth of axon cylinders into proliferating granulation tissue, but this is stopped by an undamaged epineural sleeve. We report experiments in the rat in which the epineural sleeve of the stump of the sciatic nerve was freed from nerve fascicles for about 5 mm and then sealed with a synthetic tissue adhesive. Neuroma formation was largely prevented in comparison with the results of other methods. This new technique has been used to treat 68 painful neuromas in 36 patients. All but three of the patients were cured or improved and none were made worse.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General