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Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 22-29

The surgical management of traumatic neuromas

1 Department of Plastic Surgery, Queen Elizabeth Hospital, Birmingham, UK
2 Consultant, Hand and Peripheral Nerve Surgeon, West Midlands Brachial Plexus and Peripheral Nerve Injury Service, Queen Elizabeth Hospital, Birmingham, UK

Correspondence Address:
Mr. Tom Challoner
Department of Plastic Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2GW
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmsr.jmsr_81_18

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Following injury to a peripheral nerve, a neuroma may form and cause severe debilitating neuropathic pain. End neuromas are the result of an amputation or are found at the proximal stump in a complete nerve transection or rupture. Neuromas-in-continuity follows traction or compression injury and may complicate repair of a nerve transection or rupture. Symptomatic neuromas should be assessed and treated by a peripheral nerve surgeon working within a multi-professional team. The objectives of the initial treatment should encompass pain management, psychological support and physical therapies with the aim of restoration of normal nerve response thresholds to afferent stimuli and optimisation of the perineuroma environment. Surgical intervention should be reserved for non-responders and in cases where reconstruction of nerve function is deemed essential for useful functional recovery and pain resolution.

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