Skip to main content
SpringerLink
Log in
Book cover

Chronic Postsurgical Pain pp 143–156Cite as

Scar Neuromas

  • Chapter
  • First Online:

  • 1376 Accesses

Abstract

Not all neuromas are likely to cause severe, chronic, disabling pain. The prevalence of painful neuroma varies depending on the aetiology, but the highest incidence is from 5 to 26 % in the case of neuroma after amputation. The first line of treatment is medical and is the same as the treatment of neuropathic pain. If significant reduction in pain is not achieved in 3–6 months, surgery must be considered, bearing in mind that there is no standard technique and that this decision is often made at an earlier stage in the case of amputees.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Atherton DD, Taherzadeh O, Facer P et al (2006) The potential role of nerve growth factor (NGF) in painful neuromas and the mechanism of pain relief by their relocation to muscle. J Hand Surg 31B:652–656

    Article  Google Scholar 

  2. Barbera J, Albert-Pamplo R (1993) Centrocentral anastomosis of the proximal nerve stump in treatment of painful amputation neuromas of major nerves. J Neurosurg 79:331–334

    Article  CAS  PubMed  Google Scholar 

  3. Bennett GL, Graham C, Mauldin DM (1995) Morton’s interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int 16:760–763

    Article  CAS  PubMed  Google Scholar 

  4. Birch R (2005) The peripheral neuroma. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe S (eds) Green’s operative hand surgery, 5th edn. Churchill Livingstone, New York, pp 1102–1111

    Google Scholar 

  5. Bouhassira D, Attal N (2007) Traitement pharmacologique. Douleurs neuropathiques. Arnette, Paris, pp 111–139

    Google Scholar 

  6. Boya H, Ozcan O, Oztekin HH (2008) Long term complications of open carpal tunnel release. Muscle Nerve 38:1443–1446

    Article  PubMed  Google Scholar 

  7. Burchiel KJ, Johans TJ, Ochoa J (1993) The surgical treatment of painful traumatic neuromas. J Neurosurg 78:714–719

    Article  CAS  PubMed  Google Scholar 

  8. Curtin C, Caroll I (2009) Cutaneous neuroma physiology and its relationship to chronic pain. J Hand Surg Am 34:1334–1336

    Article  PubMed Central  PubMed  Google Scholar 

  9. Dellon AL, Mackinson SE (1986) Treatment of painful neuroma by neuroma resection and muscle implantation. Plast Reconstr Surg 77:427–438

    Article  CAS  PubMed  Google Scholar 

  10. Dubner R (1997) Neural basis of persistent pain: sensory specialization, sensory modulation, and neuronal plasticity. In: Jensen TS, Turner JA, WiesenfeldHallin Z (eds) Proceedings of the 8th World Congress on Pain. IASP Press, Seattle, pp 243–258

    Google Scholar 

  11. Ducic I, Mesbahi AN, Attinger CE, Graw K (2008) The role of peripheral nerve surgery in treatment of chronic pain associated with amputation stumps. Plast Reconstr Surg 121:908

    Article  CAS  PubMed  Google Scholar 

  12. Enberg LA, Adler RS, Lane J (2003) Ultrasound in the detection and treatment of a painful stump neuroma. Skeletal Radiol 32:306–309

    Article  Google Scholar 

  13. Geraghty TJ, Jones LE (1996) Painful neuromata following upper limb amputation. Prosthet Orthot Int 20:176–181

    CAS  PubMed  Google Scholar 

  14. Gorkisch K, Boese-Landgraf J, Vaubel E (1984) Treatment and prevention of amputation neuromas in hand surgery. Plast Reconstr Surg 73:293–299

    Article  CAS  PubMed  Google Scholar 

  15. Green DP, Hotchkiss RN, Pederson WC, Wolfe S (2005) Green’s operative hand surgery, 5th edn. Churchill Livingstone, New York, pp 1102–1111

    Google Scholar 

  16. Greenfield J, Rea J Jr, Ilfeld FW (1984) Morton’s interdigital neuroma: indications for treatment by local injections versus surgery. Clin Orthop Relat Res 185:142–145

    PubMed  Google Scholar 

  17. Gruber H, Glodny B, Kopf H et al (2008) Practical experience sonographically guided phenol instillation of stump neuroma: predictors of effects, success and outcome. AJR Am J Roentgenol 190:1263–1269

    Article  PubMed  Google Scholar 

  18. Guégan Y (1998) Traumatismes des nerfs périphériques. http://www.med.univrennes1.fr/etud/neuro/traumismes_des_nerfs_peripheriques.htm

  19. Guttmann L, Medawar PB (1942) The chemical inhibition of fibre regeneration and neuroma formation in peripheral nerves. J Neurol Psychiatry 5:130

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Han HC, Lee DH, Chung JM (2000) Characteristics of ectopic discharges in a rat neuropathic pain model. Pain 84:253–261

    Article  CAS  PubMed  Google Scholar 

  21. Hebert TJ, Filan S (1998) Vein implantation for treatment of painful cutaneous neuroma: a preliminary report. J Hand Surg 23B:220–224

    Article  Google Scholar 

  22. Herndon JH, Eaton RG, Littler JW (1976) Management of painful neuromas in the hand. J Bone Joint Surg 58A:369–373

    Google Scholar 

  23. Herndon JH (1993) Neuromas in operative hand surgery, 3rd edn. Churchill Livingstone, New York, pp 1387–1400

    Google Scholar 

  24. Kluge W, Simpson RG, Nicol AC (1996) Late complications after open carpal tunnel decompression. J Hand Surg 21B:205–207

    Article  Google Scholar 

  25. Krishnan KG, Pinzer T, Schakert G (2005) Coverage of painful peripheral neuromas with vascularized soft tissues: method and results. Neurosurgery 56:369–378

    Article  PubMed  Google Scholar 

  26. Lanzetta M, Nolli R (2000) Nerve stripping: a new treatment for neuromas of palmar cutaneous branch of the median nerve. J Hand Surg 25B:151–153

    Article  Google Scholar 

  27. Lundborg G (2000) A 25 year perspective nerve surgery; evolving neuroscientific concepts of clinical signifiance. J Hand Surg 25A:391–414

    Article  Google Scholar 

  28. Mass DP, Ciano MC, Tortosa R et al (1984) Treatment of painful hand neuromas by their transfer into bone. Plast Reconstr Surg 74:182–185

    Article  CAS  PubMed  Google Scholar 

  29. Meek JF, Coert JH, Robinson PH (2005) Poor results after nerve grafting in upper extremity: quo vadis? Microsurgery 25:396–402

    Article  CAS  PubMed  Google Scholar 

  30. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979

    Article  CAS  PubMed  Google Scholar 

  31. Orza F, Boswell MV, Rosenberg SK (2000) Neuropathic pain: review of mechanisms and pharmacologic management. Neurorehabil 14:15–23

    Google Scholar 

  32. Pruimboon L, van Dam AC (2007) Chronic pain: a non-use disease. Med Hypotheses 68:506–511

    Article  Google Scholar 

  33. Rajput K, Reddy S, Shankar H (2012) Painful neuromas: a review. Clin J Pain 28:639–645

    Article  PubMed  Google Scholar 

  34. Sehirlioglu A, Ozturk C, Yazicioglu K et al (2009) Painful neuroma requiring surgical excision after lower limb amputation caused by landmine explosions. Int Orthop 32(2):32

    Google Scholar 

  35. Stokvis A, Van Der Avoort DJ, Van Neck JW et al (2010) Surgical management of neuroma pain: a prospective follow-up study. Pain 151:862–869

    Article  PubMed  Google Scholar 

  36. Soroush M, Modirian E, Masoumi M (2008) Neuroma in bilateral upper limb amputation. Orthopedics 31(12):1193

    Google Scholar 

  37. Sunderland S (1970) Anatomical features of nerve trunks in relation to nerve injury and nerve repair. Clin Neurosurg 17:38–62

    CAS  PubMed  Google Scholar 

  38. Tupper JW, Booth DM (1976) Treatment of painful neuromas of sensory nerves in the hand: a comparison of traditional and newer methods. J Hand Surg 1:144–151

    Article  CAS  Google Scholar 

  39. Vernadakis AJ, Koch H, Mac Kinnon SE (2003) Management of neuromas. Clin Plast Surg 30:247–268

    Article  PubMed  Google Scholar 

  40. Wall PD, Gutnick M (1974) Properties of afferent nerve impulses originating from a neuroma. Nature (London) 248:740–743

    Article  CAS  Google Scholar 

  41. Watson J, Gonzales M, Romero A, Kerns J (2010) Neuromas of the hand and upper extremity. J Hand Surg 35A:495–510

    Google Scholar 

  42. Yüksel F, Kislaoglu E, Durak N et al (1997) Prevention of painful neuromas by epineural ligatures, flaps, and grafts. Br J Plast Surg 50:182–185

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pain unit. Neurosurgery Department, Sainte-Anne Hospital, 1 Rue Cabanis, 75014, Paris, France

    M.-T. Gatt

Authors
  1. M.-T. Gatt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M.-T. Gatt .

Editor information

Editors and Affiliations

  1. Centre hospitalier de Voiron, Voiron, France

    Gérard Mick

  2. CHU de Clermont-Ferrand, Clermont-Ferrand, France

    Virginie Guastella

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Gatt, MT. (2014). Scar Neuromas. In: Mick, G., Guastella, V. (eds) Chronic Postsurgical Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-04322-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-04322-7_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04321-0

  • Online ISBN: 978-3-319-04322-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation