Operatieve behandeling van pijnlijke neuromen

Stand van zaken
Annemieke Stokvis en J. Henk Coert

Surgical management of painful neuroma

  • 3-5% of patients with traumatic or iatrogenic peripheral nerve injury develop a painful neuroma, especially following trauma of small cutaneous sensory nerve branches.

  • Neuroma pain is difficult to treat and often leads to loss of function and reduction of quality of life.

  • Patients with a painful neuroma present with spontaneous electric, shooting or burning pain, allodynia, hyperalgesia and cold intolerance.

  • The diagnosis is based on the medical history and physical examination, supplemented by Tinel's test and a diagnostic nerve blockade.

  • Lasting pain relief is possible by means of surgical neuroma treatment performed by a plastic surgeon.

  • Surgical treatment consists of repair or denervation of the nerve with relocation of the nerve stump in bone or muscle tissue or a vein.

  • Referral of neuroma patients without delay to a plastic surgeon or multidisciplinary consultation is important, because the symptoms become increasingly difficult to treat over time.

  • Conflict of interest: none declared. Financial support: none declared.