Treatment of painful neuromas of sensory nerves in the hand: a comparison of traditional and newer methods.

The results of treatment of 348 painful neuromas of sensory nerves of the hand in 172 patients were evaluated. Three hundred and sixteen were treated by simple excisional neurectomy and these results may be used for comparison with other methods. Sixty-five percent had an excellent or satisfactory result from a single such procedure. A repeated neurectomy improved the results to 78 percent. The use of silicone rubber caps as a secondary procedure over the nerve stump in 32 cases did not improve the results. A technique of funicular resection with epineurial ligation in 45 patients with neuromas achieved about the same percentage of good results as did simple excisional neurectomy. The ideal treatment is not at hand yet, but at the present time it is recommended that treatment should consist of excisional neurectomy, repeated at least one if necessary.