The surgical management of traumatic neuromas

Challoner, Tom; Nijran, Amit; Power, Dominic

doi:10.4103/jmsr.jmsr_81_18

Cited by 16 publications

(25 citation statements)

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“…Launched in 2016, the cap leaves a small chamber to allow unsupported neural regeneration and blocks the neuroma from adjacent tissues to prevent the typical neuronal sprouting that renders neuromas symptomatic. It degrades by hydrolysis from 12 weeks and is completely resorbed in 18 months [9].…”

Section: Methodsmentioning

confidence: 99%

Analysis of an End Neuroma 6 Months after Capping with a Bioresorbable Polycaprolactone Cap (NEUROCAP®) in a Human Model

Power¹,

George²,

Pohl³

2020

SCR

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Various methods have been described in the literature for the treatment of painful end neuromas. One technique involves capping the neuroma with a biological or synthetic material. However, failure of this technique may result from mechanical irritation of the capped nerve. In addition, the physical act of blocking the nerve end is insufficient to prevent further neuroma formation and additional measures need to be taken to halt the regenerative process of the nerve. A new technique of using a bioresorbable polycaprolactone cap (NEUROCAP®), leaving a chamber distal to the nerve ending, has been studied in animal models. The chamber results in a resultant thinner, cone shaped neuroma with a more organised fascicle structure. The chamber prevents mechanical tether or compression by scar. The cap resorbs, preventing mechanical irritation of the nerve ending. We present a case where a NEUROCAP® was excised 6 months after implantation and the nerve end was studied. This study is the first of its kind, analysed in a human model.

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Section: Methodsmentioning

confidence: 99%

Analysis of an End Neuroma 6 Months after Capping with a Bioresorbable Polycaprolactone Cap (NEUROCAP®) in a Human Model

Power¹,

George²,

Pohl³

2020

SCR

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“…It should be considered only for nerves with preserved function where excision is contraindicated or be used only as an addition to other surgical techniques for neuroma treatment. 6 There are some limitations to this analysis. In the field of neuroma surgery, randomized controlled trials with large study populations are hard to achieve.…”

Section: Ementioning

confidence: 99%

“Surgical treatment of peripheral nerve neuromas – a systematic review and meta-analysis”

Langeveld

Hundepool

Duraku

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Despite many treatment options available, no consensus on the optimal surgical management of symptomatic peripheral nerve neuroma has been reached. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of different surgical techniques for treating painful neuromas and to help guide surgeons in electing optimal treatment. Methods: Four databases (Embase, MEDLINE, Web of Science, and Cochrane Central) were searched. Studies that reported either numerical (visual analogue scale/numeric rating scale) or nonnumeric postoperative pain scores after surgical treatment of peripheral neuroma were identified. Results: Thirty-two articles met the eligibility criteria and were analyzed for qualitative review. Thirty studies were included in qualitative analysis, for a total of 1150 neuromas. Surgical treatment of peripheral neuroma achieved good postoperative results in 70 percent of treated neuromas (95 percent CI, 64 to 77 percent). Proportions between techniques ranged between 60 and 92 percent. In a post hoc analysis, targeted muscle reinnervation (82 percent; 95 percent CI, 73 to 92 percent) performed significantly better than neurectomy (p = 0.024). Conclusions: The choice of surgical management in treating symptomatic peripheral neuroma is challenging, yet surgical intervention achieves significant pain relief in the majority of cases. Targeted muscle reinnervation is promising for the management of painful neuromas.

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“…End neuromas formed from transection or amputation have other symptomatic characteristics as opposed to neuroma-in-continuity as a result of primary nerve repair and in light of these perspectives is the S-DN4 useful in highlighting possible causation or just in determining a subgroup that would benefit from further clinical screening. 43 In this study, the inclusion criteria were inclusive to ensure adequate numbers for recruitment. In this context, we estimated recalling patients for physical examination would outweigh the gain in sensitivity and specificity.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

Prevalence of post-traumatic neuropathic pain after digital nerve repair and finger amputation

Lange

Duraku

Power

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The surgical management of traumatic neuromas

Cited by 16 publications

References 0 publications

Analysis of an End Neuroma 6 Months after Capping with a Bioresorbable Polycaprolactone Cap (NEUROCAP®) in a Human Model

Analysis of an End Neuroma 6 Months after Capping with a Bioresorbable Polycaprolactone Cap (NEUROCAP®) in a Human Model

“Surgical treatment of peripheral nerve neuromas – a systematic review and meta-analysis”

Prevalence of post-traumatic neuropathic pain after digital nerve repair and finger amputation

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