Painful neuromas: A review of treatment modalities

There are numerous methods cited in the literature on the treatment of pain ful neuroma. Nonsurgical methods range from injections with various materia ls into the nerve end to desensitization of nerve pain conduction pathways. Some surgical treatments aim to alter the environment of the amputated ner ve end by transposing it into muscle or bone, others have designed various flaps to protect truncated nerve ends from scar tissue, and still others tr y to "cap" the nerve with silicon, a nerve graft, or epineurium to prevent nerve regeneration. All of these methods have proved efficient. However, no ne of these methods work universally. The authors review the common treatme nts for painful neuromas. In addition, they review the preliminary results of the extended autologous venous nerve conduit as a novel technique of tre ating painful neuromas. They also report recent investigations into the pat hophysiology of injured nerves.