• J Bone Joint Surg Br · Jun 2009

    Randomized Controlled Trial Comparative Study

    A comparative study of two methods of surgical treatment for painful neuroma.

    • H Balcin, P Erba, R Wettstein, D J Schaefer, G Pierer, and D F Kalbermatten.
    • Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland.
    • J Bone Joint Surg Br. 2009 Jun 1; 91 (6): 803-8.

    AbstractPainful neuromas may follow traumatic nerve injury. We carried out a double-blind controlled trial in which patients with a painful neuroma of the lower limb (n = 20) were randomly assigned to treatment by resection of the neuroma and translocation of the proximal nerve stump into either muscle tissue or an adjacent subcutaneous vein. Translocation into a vein led to reduced intensity of pain as assessed by visual analogue scale (5.8 (SD 2.7) vs 3.8 (SD 2.4); p < 0.01), and improved sensory, affective and evaluative dimensions of pain as assessed by the McGill pain score (33 (SD 18) vs 14 (SD 12); p < 0.01). This was associated with an increased level of activity (p < 0.01) and improved function (p < 0.01). Transposition of the nerve stump into an adjacent vein should be preferred to relocation into muscle.

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