An approach to the treatment of dorsal foot pain of neuroma origin is described based upon principals demonstrated to be effective in the treatment of upper extremity dorsoradial neuromas: translocation of the appropriate nerves into a muscle environment away from the joint. In the lower extremity, this requires identification of the appropriate nerves by anesthetic block, resection of the dorsal foot neuroma(s), and translocation of the nerves into the muscles of the anterolateral compartment. This approach yielded excellent results in 9 of the 11 patients with a mean follow-up of 29 months.
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References
1.
. BattistaA. F.CraviotoH. M.BudzilovichG. N.: Painful neuroma: changes produced in peripheral nerve after fascicle ligation. Neurosurgery, 9: 589–600, 1981.
2.
. BoldreyE.: Amputation neuroma in nerves implanted in bone. Ann. Surg., 118: 1052–1057, 1943.
3.
. DellonA. L.: Deep peroneal nerve compression over the dorsum of the foot. Foot Ankle, 11: 73–80, 1990.
4.
. DellonA. L.MackinnonS. E.: Treatment of the painful neuroma by neuroma resection and muscle implantation. Plast. Reconstr. Surg., 77: 427–438, 1986.
5.
. DellonA. L.MackinnonS. E.PestronkA.: Implantation of sensory nerve into muscle: preliminary, clinical and experimental observations on neuroma formation. Ann. Plast. Surg., 12: 30–40, 1984.
6.
. FrackeltonW. H.TeasleyJ. L.TaurasA.: Neuromas in the hand treated by nerve transposition and silicone capping. J. Bone Joint Surg. (Proceedings), 53A: 813, 1971.
7.
. GuttmanL.MedawarP. B.: The chemical inhibition of fiber regeneration and neuroma formation in peripheral nerves. J. Neurol. Neurosurg. Psychiatry, 5: 130–138, 1942.
8.
. HerndonJ. H.EatonR. G.LittlerJ. W.: Management of painful neuromas in the hand. J. Bone Joint Surg., 58A: 369–373, 1976.
9.
. HuberG. C.LewisD.: Amputation neuromas: their development and prevention. Arch Surg., 1: 85–113, 1920.
10.
. LabordeK. J.KalismanM.TsaiT. M.: Results of surgical treatment of neuromata of the hand. J. Hand Surg., 7: 190–1931920.
11.
. MackinnonS. E.DellonA. L.: Algorithm for management of painful neuroma. Contemp. Orthop., 13: 15–27, 1986.
12.
. MackinnonS. E.DellonA. L.: Results of treatment of recurrent dorsoradial wrist neuromas. Ann. Plast. Surg., 19: 54–61, 1987.
13.
. MackinnonS. E.DellonA. L.HudsonA. R.HunterD. A.: Alteration of neuroma formation produced by manipulation of neural environments in primates. Plast. Reconstr. Surg., 76: 345–352, 1985.
14.
. MoszkowitzL.: Zur Behandlung der schmerzhaften Neurome. Zentralbl. Chir., 45: 547, 1918.
15.
. MunroD.MalloryG. K.: Elimination of the so-called amputation neuromas of the divided peripheral nerves. N. Engl. J. Med., 260: 358–361, 1959.
16.
. PothE. J.FernandezE. B.DraegerJ. A.: Prevention of formation of endbulb neuromata. Proc. Soc. Exp. Biol. Med., 60: 200–207, 1945.
17.
. SmithJ. R.GomezN. H.: Local injection therapy of neuromata of the hand with triamcinolone acetonide. A preliminary study of twenty-two patients. J. Bone Joint Surg., 52A: 71–83, 1970.
. TeneffS.: Prevention of amputation neuroma. J. Int. Coll. Surg., 12: 16–25, 1949.
20.
. TupperJ. W.BoothD. M.: Treatment of painful neuromas of sensory nerves in the hand: a comparison of traditional and newer methods. J. Hand Surg., 1: 144–151, 1976.
21.
. WallP. D.: In SiegfriedJ.ZimmermannM. (Eds.)., Phantom and Stump Pain.New York, Springer-Verlag, 1981, pp. 2–14.
