Abstract
Painful neuromas and nerve compression syndromes leading to sensory or motor dysfunction of the lower extremity both represent a source of morbidity and, potentially, misery for affected patients. Surgical options for the treatment of each have been developed based on detailed anatomic knowledge and an understanding of peripheral nervous pathophysiology. Painful neuromas must be suspected when pain outlasts the typical course of an injury or surgery, and must be differentiated from complex regional pain syndrome. Nerve compression may produce sensory or motor dysfunction, and multiple overlapping nerve compressions must be differentiated from untreatable metabolic neuropathies. Before undergoing surgery, both painful neuroma and nerve compression patients should fail attempts at conservative therapy. Patients with a painful neuroma are surgical candidates if they experience a reduction in pain with a local anesthetic block at the sight of the neuroma. Patients with compression neuropathy are selected based on a combination of history and physical examination findings that may be supplemented with electrodiagnostic testing. The mainstay of surgical treatment for painful neuroma is resection of the damaged nerve with implantation to a muscle or reconstruction. Surgical treatment of compression neuropathy is release of compressive tissues surrounding the nerve, with technique guided by local anatomy.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call