Overview
Traumatic neuroma of the upper limb arises from nerve injury, often following trauma or surgical procedures, leading to benign proliferation of nerve tissue that can cause pain and functional impairment 2.Diagnosis
Clinical presentation includes localized pain, tenderness, and sometimes palpable nodules 2.
Imaging studies (e.g., MRI) may help identify neuroma but are not definitive 2.
Electromyography (EMG) and nerve conduction studies can support the diagnosis by showing abnormal nerve function 2.Management
Surgical excision is often the primary treatment, aiming to remove the neuroma and decompress the nerve 2.
Neurolysis may be performed in conjunction with excision to improve nerve function 2.
Pain management with analgesics (e.g., NSAIDs) can be adjunctive to surgical intervention 2.Special Populations
Pediatrics: Early treatment of nerve injuries to prevent contractures and neuroma formation is crucial 2.
Elderly: Consider comorbidities and functional status when planning surgical interventions 2.Key Recommendations
Early surgical excision and neurolysis for traumatic neuromas in the upper limb to prevent chronic pain and functional impairment (Evidence: Moderate 2).
In pediatric patients, prioritize early intervention to avoid long-term complications such as contractures (Evidence: Moderate 2).
For elderly patients, carefully assess overall health and functional needs before proceeding with surgical management (Evidence: Expert opinion 2).References
1 Urayama H, Harada T, Kawasuji M, Watanabe Y. Immediate haemodialysis and staged fasciotomy in the treatment of reperfusion injury. Cardiovascular surgery (London, England) 1994. link
2 Reigstad A, Hellum C. Volkmann's ischaemic contracture of the forearm. Injury 1980. link90140-0)