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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 6, 803-808.
doi: 10.1302/0301-620X.91B6.22145  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Right arrow Articles by Kalbermatten, D. F.

A comparative study of two methods of surgical treatment for painful neuroma

H. Balcin, MD, Research Fellow1; P. Erba, MD, Plastic and Reconstructive Surgeon1; R. Wettstein, MD, Plastic and Reconstructive Surgeon1; D. J. Schaefer, MD, Plastic and Reconstructive Surgeon1; G. Pierer, MD, Plastic and Reconstructive Surgeon, Departmental Director1; and D. F. Kalbermatten, MD, MPhil, Plastic and Reconstructive Surgeon1

1 Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.

Correspondence should be sent to Dr P. Erba; e-mail: erbapaolo{at}hotmail.com

Painful neuromas may follow traumatic nerve injury. We carried out a double-blind controlled trial in which patients with a painful neuroma of the lower limb (n = 20) were randomly assigned to treatment by resection of the neuroma and translocation of the proximal nerve stump into either muscle tissue or an adjacent subcutaneous vein. Translocation into a vein led to reduced intensity of pain as assessed by visual analogue scale (5.8 (sd 2.7) vs 3.8 (sd 2.4); p < 0.01), and improved sensory, affective and evaluative dimensions of pain as assessed by the McGill pain score (33 (sd 18) vs 14 (sd 12); p < 0.01). This was associated with an increased level of activity (p < 0.01) and improved function (p < 0.01).

Transposition of the nerve stump into an adjacent vein should be preferred to relocation into muscle.




eLetters:

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Intravenous lumen prevents traumatic neuroma development
Jiri Sedy
J Bone Joint Surg Br Online, 10 Sep 2009 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General