• Title/Summary/Keyword: Neuroma

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Treatment of Painful Hand Neuroma : To Make a Loop to Transpose the Nerve Ending to the Side of its Proximal Stump - Case Report - (수부 신경종의 치료 : 고리 모양의 단.측 신경봉합술의 이용 - 증례 보고 -)

  • Ko, Ra-Yong;Oh, Kap-Sung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.92-96
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    • 1999
  • Neuroma is formed by abnormal, incomplete nerve regeneration after nerve injury. A painful neuroma in the hand can be psychologically and physically disabling. The goal of treating painful neuroma is to relieve pain and to restore nerve function. A numerous treatment modality was reported for alleviating the problem. These treatments include crushing the neuroma, ligating it, burying in soft tissue, bone, and muscle, injecting it with alcohol, phenol, and steroid, capping it with silicone cuff. But, none of these methods has been uniformly successful, although each has its advocates. No one technique reliably prevents formation of a painful neuroma. However, the principles of treatment is resection of neuroma and proximal stump of the nerve is transposed to appropriate adjacent tissue. Our current technique was resection of neuroma with partial normal neural tissue, and then the nerve ending was transposed and sutured to the side of the proximal stump with 10-0 nylon, so end-to-side neurorrhaphy was made. The nerve ending had to be placed and fixed into the proximal nerve epineurium like as a figure of a loop. We believe this technique is another useful method for the treatment of painful neuroma.

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Diagnosis of Morton's Neuroma Using MR Imaging scans (지간 신경종의 자기 공명 영상을 이용한 진단)

  • Hong, Ki-Do;Ha, Sung-Sik;Sim, Jae-Cheon;Kim, Jae-Young
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.131-134
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    • 2003
  • Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

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The Comparison of Ultrasonographic Size of Morton's Neuroma measured to Actual Size (Morton씨 지간 신경종의 초음파검사상 크기와 실제 크기의 비교)

  • Kim, J-Young;Lee, Kyung-Tae;Young, Ki-Won;Son, Sang-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.80-83
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    • 2006
  • Purpose: To compare ultrasonographic size of morton's neuroma measured to actual size. Materials and Methods: Thirty-two (twenty-eight patients) of symptomic Morton's neuroma were measured by ultrasonography preoperatively and by manual method that designed by authors intraoperatively from January, 2002 to May, 2003. Two results were stastically compared by paired T-test. Results: Except one, all of cases were women and the mean age of patients was 50.6 years (32-62 years). The most common associated disease was hallux valgus deformity (17 cases). Six of Morton's neuromas located on second intermetatarsal space, sixteen of them did third intemetatarsal space and ten of neuromas located simultaneously second and third intermetatarsal space. The ultrasonographic size of neuroma averaged 3.48 mm and real size was 3.99 mm. The size checked by manual method was larger than by ultrasound with statical meaning. Conclusion: The size of Morton's interdigital neuroma checked by ultrasonography on plantar aspect is smaller than real size. If you checked Morton's interdigital neuroma size by ultrasonography, you can suspect that real size of Morton's interdigital neuroma is larger than that size.

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A Clinical Result of Treatment of Interdigital Neuroma with Decompression (4 Cases Report) (족지간 신경종의 감압술을 통한 임상적 치료 결과 (4예 보고))

  • Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.106-110
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    • 2008
  • Morton's neuroma has been treated with resection of the enlarged interdigital nerve by most of surgeons, but the numbness after resection could bother the patients. We reported the experiences of the good results after treatment of Morton's neuroma with the decompression of the interdigital nerve. Three patients, 4 feet were diagnosed to Morton's neuroma and taken the surgery, decompression of the interdigital nerve after the conservative treatments. The decompression can be considered first as another choice of treatment for interdigital neuroma before resection of the nerve.

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Clinical Result of Conservative Treatment and Operative Treatment for Interdigital Neuroma (지간 신경종에서 보존적 치료 및 수술적 치료의 임상적 결과)

  • Lee, Jin-Woo;Han, Seung-Hwan;Suh, Dong-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.31-36
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    • 2006
  • Purpose: To evaluate the usefulness of ultrasound and MRI in diagnosing Morton's Neuroma, and the effect and significance of stepwise treatment. Materials and Methods: Out of all patients suspected of Morton's neuroma through history taking and physical examination, 77 patients (84 feet, 95 lesions) in whom Morton's neuroma was confirmed by ultrasound or MR imaging study or was clinically suspected with negative imaging studies, and followed up for over 3 months were included. In all cases, history taking and imaging study were done, and by comparison with operative findings of the patients, the sensitivity of ultrasound and MRI was checked. Postoperative evaluation was done using the AOFAS scale. The patient's satisfaction was also examined. Results: Morton's neuroma occurred most frequently at the $3^{rd}$ web space of the foot (56%), followed by the $2^{nd}$ web space (44%). Out of 15 cases suspected of morton's neuroma through ultrasound study, 13 were pathologically positive showing a sensitivity of 85.7%. Out of 16 cases suspected of morton's neuroma through MRI, 14 were pathologically positive showing a sensitivity of 83.3%. There was no significant difference in sensitivity between the two imaging modalities. Conclusion: In diagnosing Morton's neuroma, ultrasound examination had a similar sensitivity with MRI, therefore can be used as a screening study.

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Anatomical Study of Interdigital Neuroma Occurring Site and the Deep Transverse Metatarsal Ligament (DTML) (지간 신경종 발생 위치와 심부 횡 중족 골간 인대의 해부학적 연구)

  • Kim, J-Young;Choi, Jae-Hyuck;Lee, Kyung-Tai;Young, Ki-Won;Park, Jung-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.182-186
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    • 2007
  • Purpose: We examined the relationship of interdigital neuroma occurring site and the surrounding structures, including the deep transverse metatarsal ligament (DTML) by cadaver study and clinical results. Materials and Methods: Seventeen fresh frozen cadavers study were done to evaluate the relationship of interdigital neuroma occuring site and the DTML at two phase of the gait cycle with 60 degree of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from interdigital nerve bifurcation of the common digital nerve to anterior margin of the DTML and longitudinal length of DTML itself. Clinically, we checked the location of interdigital neuroma and DTML length during surgery in 32 feet. Results: In the second and third web space, the mean distance from bifurcation of the common digital nerve of foot to the anterior margin of DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm. 14.6 mm in heel-off position. Second, Third web space ligament itself length were average 12.8 mm, 10.6 mm. Clinically, all of the cases of interdigital neuroma started at the bifurcation area of the common digital nerve and interdigital neuroma was average 7.5 mm (range; 6-11 mm). Conclusion: Interdigital neuroma were located more distally than DTML in both the mid-stance and heel off stage. The main lesion was located between metatarsal head and metatarsophalangeal joint and more distal than the DTML anterior margin.

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Traumatic Neuroma Following Mandibular Angle Reduction : A Case Report

  • Oh, Ji-Su;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong;Lim, Sung-Chul;Yoon, Jung-Hoon;Ahn, Sang-Gun
    • Journal of Korean Dental Science
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    • v.2 no.1
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    • pp.39-41
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    • 2009
  • A traumatic or amputation neuroma can develop as a result of nerve injury caused by hemorrhage, infection, ischemia, trauma, etc. A traumatic neuroma can be considered as the attempted regeneration of the amputated nerve rather than a true neoplasm. Occasionally, a traumatic neuroma will develop after oral or maxillofacial surgery. Here, we report a case of traumatic neuroma after mandibular angle reduction in a 24-year-old woman.

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Treatment of Recurrent Neuroma after Forearm Amputation: End to End Neurorrhaphy

  • Roh, Youn-Tae;Kim, Hyoung-Min;You, Sung-Lim;Kim, Chol-Jin;Park, Il-Jung
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.86-89
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    • 2013
  • The neuroma is a tumor of nerve tissue that partially or completely severed through incomplete regeneration process. Neuromas that formed in the stump of a limb following amputation is a cause of the stump pain and can make intractable pain. The authors report a rare case of 36-year-old man with neuroma at stump, which has been recurred three times. This patient was treated with end-to-end neurorrhaphy after resecting neuroma. Follow-up at out-patient clinic showed satisfied result.

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TRAUMATIC NEUROMA : FOUR CASES REPORT (외상성신경종 4례)

  • Jang, Hyun-Seon;Kim, Su-Gwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.357-360
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    • 2001
  • The traumatic neuroma is uncommon in the mouth. Clinically, the majority of traumatic neuromas are painless, but may give rise to neuralgic pain. The traumatic neuroma is most often diagnosed in the adult of life. They are found as small nodules in the tissues and surgical excision is curative. Four cases of traumatic neuroma was found from the files of the Department of Oral Pathology at Chosun University School of Dentistry by a 20-year retrospective study. 3 cases were male and one was female. The chief complaint of the four patients was facial asymmetry, numbness, sharp pain, and masticatory difficulty, respectively. Of the our patients, 3 cases were 55, 56, and 65 years old, respectively and one was 7 years old. Our patients were treated by surgical excision. No recurrences have been found.

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