title: Post-traumatic neuroma due to closed nerve injury. Is recovery after peripheral nerve trauma related to ultrasonographic neuroma size?
abstract: OBJECTIVE
  traumatic neuroma is a pathological condition of peripheral nervous system consisting of localized proliferation of injured nerve elements. The symptoms depend on the type of involved nerve (motor and/or sensitive) and on the site and the extension of the lesion. Ultrasound is the best tool to depict the morphology of nerve, especially in traumatic conditions. We present a study aimed to assess the correlation between the degree of nerve function and the ultrasound morphology of neuromas.
  
  
  METHODS
  we retrospectively evaluated 18 patients with neuromas (not transected) occurred after a closed nerve trauma evaluated with clinical and ultrasound assessment. The clinical evaluation was related to the % of increase of cross sectional area as detected by nerve ultrasound respect to normal nerve.
  
  
  RESULTS
  we observed that dimensions of neuromas are not related to function until neuroma have cross sectional area 5 times enlarged respect to normal nerve, in this case recovery never occurs.
  
  
  CONCLUSIONS
  our study failed to clear detect a relation between cross sectional area enlargement of neuroma and nerve function, but showed a cut off beyond which prognosis is negative. This result provide some useful information for prognosis, nevertheless we believe that future perspective studies are needed to better understand the timing of developing neuromas and its evolution.
authors.affiliation: Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy; Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Coraci
authors.affiliation: Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
authors.forename: Costanza
authors.initials: C
authors.lastname: Pazzaglia
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: Pietro Emiliano
authors.initials: PE
authors.lastname: Doneddu
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Erra
authors.affiliation: Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Paolasso
authors.affiliation: Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy; Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Santilli
authors.affiliation: Don Carlo Gnocchi ONLUS Foundation, Milan, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: lpadua@rm.unicatt.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D059348:Peripheral Nerve Injuries / Q000150:complications / Q000503:physiopathology*; D010524:Peripheral Nervous System Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D047368:Tumor Burden; D014463:Ultrasonography
keywords: Neuroma; Peripheral nerve trauma; Rehabilitation; Surgery; Ultrasound