title: Neuromas of the hand and upper extremity.
abstract: The painful neuroma is an often debilitating sequela of nerve injury about the hand. The exact pathophysiology of this condition is poorly understood. After sharp trauma to a peripheral nerve, as nerve ends try to connect with their end organs and "find" the distal nerve stump, fascicular escape and scarring can lead to the development of a painful neuroma. Painful neuromas can even be associated with blunt trauma or retraction of a nerve when the nerve is not actually divided. Green's definition of a neuroma is "the inevitable, unavoidable, and biologic response of the proximal stump after it has been divided in situations where regenerating axons are impeded from re-entering the distal stump."(1) A number of unknown factors make certain patients more susceptible to neuroma formation. In addition, certain nerves such as the superficial radial nerve are more prone to the development of a painful neuroma. Treatment of neuromas of the hand is important because they can be quite debilitating and painful, often preventing patients from continuing with their normal daily activities. There are a number of approaches to the painful neuroma, and the treatment plan must be tailored to the individual patient.
authors.affiliation: University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Watson
authors.forename: Mark
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Alex
authors.initials: A
authors.lastname: Romero
authors.forename: James
authors.initials: J
authors.lastname: Kerns
mesh_terms: D006225:Hand / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009416:Nerve Regeneration; D009463:Neuroma / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D010147:Pain Measurement; D010524:Peripheral Nervous System Neoplasms / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps; D034941:Upper Extremity / Q000503:physiopathology / Q000601:surgery*