Safe and Effective Management of Symptomatic Nerve-End Neuroma
Peripheral nerve dissection following trauma due to injury or surgery may result in symptomatic end-neuromas, a swelling at the end of the nerve which can cause significant pain. Neuroma-induced neuropathic pain and morbidity causes serious difficulties in the daily lives and socio-economic functioning of patients.
The incidence rate of symptomatic neuromas after peripheral nerve injury is estimated at 3-5%. However, for certain surgeries, including autograft procedures and amputations, this increases to 30%.
Although there are several existing procedures used to treat symptomatic end-neuromas, these require complex surgeries or use materials of human or animal origin and show highly variable results. The most common is to surgically remove the neuroma and surrounding scar tissue and burying the proximal stump in an area of minimal mechanical stimulation. Using these procedures, 86% of patients experience minimal to no improvement and on average must undergo 2.8 re-interventions after initial treatment of the neuroma.