Prevention and treatment of painful neuromas of the superficial radial nerve by the end-to-side nerve repair concept: an experimental study and preliminary clinical experience.

This article studies the utilization of the end-to-side neurorrhaphy concept in the prevention and treatment of painful neuromas. A total of 20 rats were divided into 2 groups (10 rats per group). In group A, the tibial nerve was divided and left lying in the subcutaneous tissue. In group B, the cut ends of the tibial nerve were sutured to the adjacent peroneal nerve in an end-to-side fashion. Evaluation was performed 90 days after nerve injury. For group A, the proximal end of the tibial nerve formed a "classic" neuroma and the distal end showed a degenerated nerve. In group B, the proximal end of the tibial nerve formed a "non-classic" neuroma and the nerve healed into the peroneal nerve with continuity of the epineurium of the 2 nerves. The distal end of the tibial nerve in group B showed evidence of axonal regeneration. Preliminary clinical experience utilizing the same technique in the prevention and treatment of painful neuromas of the superficial radial nerve is presented and other techniques of nerve-to-nerve implantation are discussed.