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Eftekari et al. Plast Aesthet Res 2022;9:43 Plastic and
DOI: 10.20517/2347-9264.2022.33
Aesthetic Research

Review Open Access

Management of symptomatic neuromas: a narrative
review of the most common surgical treatment

modalities in amputees

Sahand C. Eftekari, Peter J. Nicksic, Allison J. Seitz, D’Andrea T. Donnelly, Aaron M. Dingle, Samuel O.
Poore

Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, G5-347 Clinical Sciences Center,
Madison, WI 53711, USA.
Correspondence to: Dr. Samuel O. Poore, Division of Plastic Surgery, University of Wisconsin School of Medicine and Public
Health, G5-347 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53711, USA. E-mail: poore@surgery.wisc.edu
How to cite this article: Eftekari SC, Nicksic PJ, Seitz AJ, Donnelly DT, Dingle AM, Poore SO. Management of symptomatic
neuromas: a narrative review of the most common surgical treatment modalities in amputees. Plast Aesthet Res 2022;9:43.
https://dx.doi.org/10.20517/2347-9264.2022.33

Received: 30 Mar 2022 First Decision: 18 May 2022 Revised: 30 May 2022 Accepted: 17 Jun 2022 Published: 1 Jul 2022

Academic Editors: Matthew Iorio, Joseph M. Rosen Copy Editor: Peng-Juan Wen Production Editor: Peng-Juan Wen

Abstract
Symptomatic neuromas are an all-too-common complication following limb amputation or extremity trauma,
leading to chronic and debilitating pain for patients. Surgical resection of symptomatic neuromas has proven to be
the superior method of intervention, but traditional methods of neuroma resection do not address the underlying
pathophysiology leading to the formation of a future symptomatic neuroma and lead to high reoperation rates.
Novel approaches employ the physiology of peripheral nerve injury to harness the regeneration of nerves to their
advantage. This review explores the underlying pathophysiology of neuroma formation and centralization of pain
signaling. It compares the traditional surgical approach for symptomatic neuroma resection and describes three
novel surgical strategies that harness this pathophysiology of neuroma formation to their advantage. The
traditional resection of symptomatic neuromas is currently the standard of care for amputation patients, but new
techniques including the regenerative peripheral nerve interface, targeted muscle reinnervation, and intraosseous
transposition have shown promise in improving patient pain outcomes for postamputation pain and residual limb
pain. Symptomatic neuromas are a chronic and debilitating complication following amputation procedures and
trauma, and the current standard of care does not address the underlying pathophysiology leading to the formation
of the neuroma. New techniques are under development that may provide improved patient pain outcomes and a
higher level of care for symptomatic neuroma resection.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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