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Management of a Painful Neuroma

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The Arm Clinic
The Arm Clinic

Presentation by Mr CY Ng at The Arm Clinic Educational Evening, 30th June 2016.

Health & Medicine
1 of 7
Management of a Painful Neuroma C.Y. Ng Consultant Hand & Peripheral Nerve Surgeon Wrightington Hospital
Overview • What is pain? • Non-surgical treatment of a painful neuroma • Surgical treatment of a painful neuroma • Case discussion
Decision Making • Which nerve is involved? • What type of nerve? Sensory / motor / mixed • Is the nerve cut or in-continuity? • Is the nerve sacrificable? Pain vs function • What is patient’s (surgeon’s) expectation?
Treatment Targets
Surgical Options • Neurolysis +/- wrapping • Nerve repair / grafting • Nerve burial / relocation • Nerve transfer
Surgical Principles • Move it out of harm’s way! • Give the nerve something to do!
Conclusions • Painful neuroma – Challenging condition • Can be very rewarding & frustrating to treat • Multi-disciplinary & multi-modality approach

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Management of a Painful Neuroma

  • 1. Management of a Painful Neuroma C.Y. Ng Consultant Hand & Peripheral Nerve Surgeon Wrightington Hospital
  • 2. Overview • What is pain? • Non-surgical treatment of a painful neuroma • Surgical treatment of a painful neuroma • Case discussion
  • 3. Decision Making • Which nerve is involved? • What type of nerve? Sensory / motor / mixed • Is the nerve cut or in-continuity? • Is the nerve sacrificable? Pain vs function • What is patient’s (surgeon’s) expectation?
  • 5. Surgical Options • Neurolysis +/- wrapping • Nerve repair / grafting • Nerve burial / relocation • Nerve transfer
  • 6. Surgical Principles • Move it out of harm’s way! • Give the nerve something to do!
  • 7. Conclusions • Painful neuroma – Challenging condition • Can be very rewarding & frustrating to treat • Multi-disciplinary & multi-modality approach