A comparative study of two methods of surgical treatment for painful neuroma.
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.
Balcin
H
H
Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland.
Erba
P
P
Wettstein
R
R
Schaefer
D J
DJ
Pierer
G
G
Kalbermatten
D F
DF
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000601:surgery*; D010146:Pain / Q000523:psychology / Q000601:surgery; D010147:Pain Measurement; D017060:Patient Satisfaction; D010525:Peripheral Nerves / Q000637:transplantation; D011446:Prospective Studies; D055815:Young Adult