Painful stump neuromas in lower limb amputees are a significant burden on a person’s quality of life due to interference with wearing prostheses and therefore the ability to walk. Treating painful stump neuromas is a challenge perhaps reflected by the lack of clinical guidelines.
A systematic review was conducted to evaluate the efficacy of all treatments tried in the management of symptomatic neuromas in the lower limb amputation stump in order to establish whether one treatment is superior.
Twenty-two studies were included in the final review which examined 14 different treatments both surgical and nonsurgical. Results showed that no single treatment showed superiority.
The 4 treatments that showed most promise included targeted nerve implantation, traction neurectomy, nerve-to-nerve anastomosis, and perineurial gluing. The short follow-up times and small sample sizes of the studies highlighted the need for more robust clinical studies.
*Foundation Year 2 Doctor
†Departments of Plastic Surgery
‡Anaesthetics, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane, Preston, PR2 9HT
§Manchester Institute of Biotechnology, Faculty of Science and Engineering
No funding was received from the National Institute of Health, Wellcome Trust, Howard Hughes Medical Institute or any others.
The work for this paper was carried out at the Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane, Preston, PR2 9HT.
The authors declare no conflict of interest.
Reprints: Stephanie A. Poyntz, MBChB Hons, 9 Old Wickham Lane, Haywards Heath, West Sussex, RH16 1UP, UK (e-mail: email@example.com).
Received June 23, 2016
Received in revised form October 5, 2016
Accepted June 23, 2017