Treatment of Postsurgical Neuroma in Foot and Ankle Surgery

Hendrickson, Nathan R.; Cychsoz, Christopher C.; Akoh, Craig C.; Phisitkul, Phinit

doi:10.1177/2473011418764452

Cited by 6 publications

(4 citation statements)

References 52 publications

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“…Clinical trials evaluating surgical treatment of neuromas in the lower extremity are small and often demonstrate variable outcome metrics. As such, there is no universally accepted standard of care for surgical treatment of painful neuromas 10 …”

Section: Discussionmentioning

confidence: 99%

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A Cohort Study on Neuropathic Pain of the Sural Nerve—Can Neurectomy Be Considered a Valid Treatment Option?

et al. 2022

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BackgroundSural nerve neuroma is often caused by an injury during prior surgery, for example, osteosynthesis or ligament refixations at ankle level. Different surgical techniques to treat neuroma have been described. Neurectomy of an injured symptomatic sural nerve has been described as a treatment option for neuropathic pain. The aim of this study was to evaluate the outcomes of this technique to operatively treat sural nerve neuroma in our department.MethodsFrom 2010 to 2020, a total of 30 consecutive patients with neuropathic pain and suspected neuroma of the sural nerve underwent sural nerve neurectomy. A medical chart review was performed to collect patient-, pain-, and treatment-specific factors. Outcomes were registered.ResultsAfter neurectomy, 22 patients (73.3%) had persisting pain. In logistic regression models evaluating the risk of persisting pain after sural nerve neurectomy, no independent predictor of higher risk of persisting pain could be identified.ConclusionFor sural nerve neuromas, neurectomy remains an option as the surgical morbidity is minor, but patients need to be counseled that only a fourth of those undergoing surgery will be pain-free afterward.

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Section: Discussionmentioning

confidence: 99%

“…As such, there is no universally accepted standard of care for surgical treatment of painful neuromas. 10 The sural nerve lies superficial in the distal fourth of the leg and the foot and can be damaged during surgeries in the ankle area or through direct trauma. 11 The sural nerve is the most frequently harvested nerve autograft.…”

Section: Discussionmentioning

confidence: 99%

A Cohort Study on Neuropathic Pain of the Sural Nerve—Can Neurectomy Be Considered a Valid Treatment Option?

et al. 2022

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“…While syndesmotic injuries are associated with ankle fractures (especially Weber C), they can also be limited to ligamentous injuries. The superficial peroneal nerve (SPN) is a branch of the common peroneal nerve which bifurcates into a deep peroneal branch and a superficial peroneal branch at the level of the fibular head 2 3. The sensory branch of the SPN supplies the lateral ankle and dorsum of the foot.…”

Section: Discussionmentioning

confidence: 99%

Superficial peroneal nerve neuroma after syndesmotic stabilisation surgery

et al. 2021

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“…After resection of a neuroma, the stump of the nerve will attempt to grow back, but without the Schwann cells, the nerve grows sporadically. There are treatments for nerve pain such as Gabapentin, Pregabalin, Tricyclic antidepressants, Steroid injections, physical therapy, and orthotics [2] . A newer treatment modality for stump neuroma is Low Level Laser Therapy, where a 10mW to 500mW laser with a wavelength within the visible red light spectrum is used to cause photochemical changes in the nerve, preventing further growth and pain.…”

Section: Introductionmentioning

confidence: 99%

A case report of usage of luminex 500 in treatment of stump neuroma

Shah,

Malhotra,

Blanca

et al. 2024

Int. J. Case Rep. Orthop.

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Background: A stump neuroma is a possible sequelae of any surgery where a nerve is cut, or in this case specifically, when a neuroma is removed. It is due to the nerve's attempt to regenerate, however, without the Schwann cells intact, the nerve grows sporadically in a bulb like fashion causing significant localized pain. Case Presentation: A 23-year-old male presented to the clinic with shooting pain in his right foot and was diagnosed with both a Morton and Hauser neuroma. Conservative treatment modalities and glucocorticoid injections were unable to resolve the pain in the neuromas, leading to surgical removal which provided temporary relief. Following the surgery, the patient presented with similar pain just proximal to the incision site, which was diagnosed as a stump neuroma. After an unsuccessful trial of conservative treatment, the patient was successfully treated with Luminex 500 laser therapy, and was able to return to normal activities of daily living. Discussion: Treatment of nerve injuries such as a stump neuroma may be more adequately treated with the use of Low Level Laser Therapy such as the Luminex 500. However, more research is needed to determine which laser parameters must be set for optimal treatment of nerve injuries. It is important for clinicians to keep laser therapy in mind when determining treatment of a stump neuroma, or other nerve injuries.

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Treatment of Postsurgical Neuroma in Foot and Ankle Surgery

Cited by 6 publications

References 52 publications

A Cohort Study on Neuropathic Pain of the Sural Nerve—Can Neurectomy Be Considered a Valid Treatment Option?

A Cohort Study on Neuropathic Pain of the Sural Nerve—Can Neurectomy Be Considered a Valid Treatment Option?

Superficial peroneal nerve neuroma after syndesmotic stabilisation surgery

A case report of usage of luminex 500 in treatment of stump neuroma

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