Treatment of refractory pain caused by neuroma by double end-to-side neuroanastomosis

JIANG Qi-ting; WANG Yu; YANG Li-na; FENG Ming-sheng; JIANG Zhi-wei

Abstract：Objective To introduce a new method to treat the refractory pain caused by neuroma .Meth-ods From Feb.2005 to Mar.2011,11 fingers in 11 patients with refractory pain caused by neuroma were treated by double end-to-side neuroanastomosis .Neuroma was completely removed until observing normal nerve bundles , then bilateral distal ends and proximal ends were sutured ,respectively;two neural archs were formed;the spacing of the two nerve bows was measured .The cutaneous antebrachii lateralis nerve with similar diameter was freed and di-vided equally into 2 parts for achieving anastomosis .Results Primary healing of incision was achieved in all ca-ses.The postoperative follow-up interval ranged from 24.5 to 52 months,with an average of (38 ±2.5) months. Nine patients experienced complete pain relief ,and there was no recurrence at 2 years postoperatively .Two patients experienced spontaneous pain relief ,but there was still mild tenderness .According to the Burchiel ’ s evaluation cri-teria,the results were excellent in 9 cases,good in 2 cases,the excellent and good rate was 100%.The sensation measurement ranged from S3 to S4 and the two point discrimination ranged from 4.5 to 6.5mm.Conclusion Double end-to-side neuroanastomosis is an effective method for treating refractory pain caused by neuroma ,which can relieve figures’ pain and recover the sensitivity of finger pulp .