Outcomes of upper extremity sensory neuromas treated with excision and burial.

Background: Upper extremity sensory neuromas can be extremely debilitating leading to pain and dysfunction. Surgical management of neuromas can either be ablative or reconstructive. The primary aim of this study was to examine the outcomes of surgically treated sensory neuromas within the forearm, wrist, and hand with exclusion of digital neuromas. Methods: A retrospective review was conducted of patients surgically treated for an upper extremity sensory neuroma from a multi-surgeon, single institution database. The types of neuroma, mechanism of injury and the surgical technique utilized for treatment were documented. Patient reported outcomes were collected including resolution of symptoms, pain scores, complications, and need for revision surgery. Averages and proportions were used for analysis. Results: 79 patients were included with mean age of 42.3 years and an average follow-up of 6.7 months. The types of sensory neuromas included 23 dorsal radial sensory, 21 medial antebrachial cutaneous, 15 palmar cutaneous, and 14 dorsal ulnar sensory. Single isolated cases of neuromas were more common (94.9%) than multiple neuromas (5.1%). 67.1% (53/79) of patients experienced pain or hypersensitivity with a mean improvement of 2.0 in the visual analog scale (VAS) following surgery. 6.3% (5/79) required revision surgery, and 82% returned to work in some capacity. Conclusion: Surgical excision of neuroma and burial into local surrounding tissue can be safely performed with a relatively low reoperation rate. 80% of patients had full resolution or improvement in their symptoms.