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Relocation of Painful End Neuromas and Scarred Nerves from the Zone II Territory of the Hand

From the Hand Surgery Department, St. Andrew’s Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK

Correspondence: Mr D. Elliot MA, FRCS, Hand Surgery Department, St Andrew’s Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK. Tel.: +44 1245 440761; fax: +44 1245 516132. E-mail:info{at}david-elliot.co.uk

This paper reports the results of treatment by proximal relocation of 46 painful end-neuromas or scarred nerves in 33 patients from the pre-defined Zone II of the hand. The relocated nerves included four palmar cutaneous branches of the median nerve, 17 dorsal branches of the ulnar nerves and 25 digital nerves. If no pain at the original site and no pain or only mild pain at the relocation site are considered an adequate treatment of these difficult problems, these relocation procedures achieve complete control of spontaneous baseline pain, complete control of spontaneous spikes of pain, 93% control of direct pressure pain, complete control of movement pain (excluding the extremes of movement of the wrist into extension, supination and, less frequently, pronation) and 96% control of hypersensitivity of the overlying skin.

Key Words: nerve pain • end-neuroma • neuroma-in-continuity • scarred nerve • nerve relocation

Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 38-44 (2007)
DOI: 10.1016/j.jhsb.2006.10.013


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