Treatment by collagen conduit of painful post-traumatic neuromas of the sensitive digital nerve: a retrospective study of 10 cases.
OBJECTIVE
The purpose of this retrospective study was to report the results of surgery in painful post-traumatic neuromas of the digital nerves treated by collagen conduits after excision of the neuromas, when two stumps were available.


METHODS
We retrospectively reviewed all patients operated on for painful neuroma in our institution and having undergone repair with collagen conduits. Their files were retrieved by a coding file (CCAM version 10). Ten patients involving nine digital nerves and one common digital nerve were included. Primary outcome data points were static two-point discrimination, Semmes-Weinstein monofilament testing, Quick-Dash outcome survey scores, Cold Intolerance Symptom Severity (CISS) score and recurrence of pain at final follow-up. We set up a minimum follow-up period of 6 months after surgery.


RESULTS
The patients' average age was 30 years. The average follow-up duration was 11.8 months. Five patients had excellent or good results (50%) at static two-point discrimination testing. Semmes-Weinstein monofilament testing results were full, diminished light touch or diminished protective sensation in nine digits (80%). The average Quick-Dash survey score was 19.3. The average CISS score was 27.8. There was no recurrence of pain.


CONCLUSIONS
Our findings indicate that collagen conduit is an effective treatment for post-traumatic painful neuromas of digital nerves and common digital nerves.
Thomsen
L
L
Hôpital universitaire Saint-Antoine, AP-HP, Paris, France. laurentthomsen@hotmail.fr
Bellemere
P
P
Loubersac
T
T
Gaisne
E
E
Poirier
P
P
Chaise
F
F
D000293:Adolescent; D000328:Adult; D000672:Amputation Stumps; D003094:Collagen; D005260:Female; D005385:Fingers / Q000294:innervation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017169:Neoplasms, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D009416:Nerve Regeneration; D009463:Neuroma / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis / Q000628:therapy*; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D012677:Sensation / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003094:Collagen