Local Injection Therapy of Neuromata of the Hand with Triamcinolone Acetonide

Abstract

Thirty-four post-traumatic and postoperative neuromas of the hand, in twenty-two patients, were treated by intralesional injection of a solution of triamcinolone acetonide, ten milligrams per milliliter. The tenderness or paresthesia, or both, of fifteen neuromas in eleven patients was eliminated after a single injections. Subtotal remission of these symptoms followed two or three injections of four neuromas in four patients, while the tenderness, paresthesia, or hyperesthesia of five neuromas in three patients decreased after multiple injections leaving significant residual symptoms. The symptoms of nine neuromas in five patients (excluding pain) failed to respond to triamcinolone injection therapy. Of the seven patients who complained initially of pain (fourteen neuromas) in addition to tenderness or paresthesia, or both, only one reported any pain reduction which seemed to be related to the intralesional therapy of his single neuroma. It is surmised that relief of neuroma tenderness after intralesional injection of triamcinolone is related to softening and atrophy of scar in and around the neuroma site. Additional studies are indicated to define the practical application of triamcinolone injection in the therapy of neuromas of the hand. The present findings suggest that a trial of this technique prior to surgical treatment is warranted. The method may be a simple alternative to surgery.