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Hand & Upper Limb
advanced
X-Type

Neuroma Management in the Hand

Neuroma Management

A 34-year-old mechanic underwent index finger amputation through the proximal phalanx 18 months ago following a crush injury. He presents with severe lancinating pain at the amputation stump, exacerbated by light touch and gripping tools. Tinel's sign is strongly positive over the radial digital nerve. Previous treatments including desensitization therapy, gabapentin, and local steroid injections have failed. Regarding the management of symptomatic peripheral nerve neuromas:

Mark each as TRUE or FALSE

A

Neuromas are classified as terminal (end neuromas at amputation sites) or neuromas-in-continuity (fo...

B

Targeted Muscle Reinnervation (TMR) involves transferring the painful nerve end to a nearby motor ne...

C

Simple neuroma excision with burial of the nerve end in muscle or bone is the gold standard treatmen...

D

Regenerative Peripheral Nerve Interface (RPNI) involves wrapping the nerve end in a free muscle graf...

E

Preoperative assessment should include diagnostic nerve block to confirm the neuroma as the pain sou...

Answer the questions to see explanations

Click T (True) or F (False) for each option