Neuromas of the Hand and Upper Extremity

作者：Watson Jonathan; Gonzalez Mark^*; Romero Alex; Kerns James

来源：Journal of Hand Surgery-American Volume, 2010, 35A(3): 499-510.

DOI：10.1016/j.jhsa.2009.12.019

• Hand surgery
• neuroma
• nerve
• nerve injury
• nerve repair

The painful neuroma is an often debilitating sequela of nerve injury about the hand. The exact pathophysiology of this condition is poorly understood. After sharp trauma to a peripheral nerve, as nerve ends try to connect with their end organs and "find" the distal nerve stump, fascicular escape and scarring can lead to the development of a painful neuroma. Painful neuromas can even be associated with blunt trauma or retraction of a nerve when the nerve is not actually divided. Green's definition of a neuroma is "the inevitable, unavoidable, and biologic response of the proximal stump after it has been divided in situations where regenerating axons are impeded from re-entering the distal stump."(1) A number of unknown factors make certain patients more susceptible to neuroma formation. In addition, certain nerves such as the superficial radial nerve are more prone to the development of a painful neuroma. Treatment of neuromas of the hand is important because they can be quite debilitating and painful, often preventing patients from continuing with their normal daily activities. There are a number of approaches to the painful neuroma, and the treatment plan must be tailored to the individual patient. (J Hand Surg 2010;35A:499-510.

• 出版日期2010-3