الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Digital neuroma is a condition characterized by the abnormal growth of nerve tissue, composed of disorganized structures such as axons, Schwann cells, macrophages, and fibroblasts. This growth occurs as a result of the biological response to nerve trauma or a failed nerve repair. The formation of neuromas can be caused by various peripheral nerve injuries, including lacerations, crush injuries, chronic irritation or stretch, or post-nerve repair (Regal and Tang, 2019).
The study aimed to synthesize and critically appraise the current available evidence regarding the various surgical options for treating painful digital neuromas and to determine the most effective and safe approach. The review aimed to provide guidance to surgeons and patients in making informed decisions regarding the treatment of painful digital neuromas.
In this systematic review, a variety of surgical techniques were evaluated for the treatment of painful digital neuromas, including Centro-central union, proximal relocation, neurovascular island flap, collagen conduit, nerve allograft reconstruction, nerve auto-raft, nerve repair, regenerative peripheral nerve interface, thermal ablation(RF),muscle-in-vein conduits (MVCs).
The results suggest that surgical treatment is effective in reducing pain levels, with most patients reporting complete pain relief or improvement. The studies included in the review measured pain using various methods such as the VAS scale, Dash scale,2 point discrimination, SW monofilament test and hand grip test, and found an improvement in pain scores post-operatively with high levels of patient satisfaction.
Neuroma excision followed by nerve repair/reconstruction was found to result in better outcomes compared to neuroma excision alone with or without implantation. However, it is noted that a small number of patients still reported mild persistent pain or required analgesia post-operatively, and some patients may have experienced loss of sensation in the affected digit. The study’s limitations include the inability to assess if a specific surgical technique was better than others.
To address these limitations and improve the understanding of digital neuroma formation, it is recommended that further studies be conducted with unified assessment parameters. This can provide valuable insight into the development of digital neuromas and help identify potential risk factors.
Additionally, it is recommended that surgeons work in conjunction with pain specialists to analyze surgical outcomes and techniques. This collaboration can ensure that patients receive the best possible care and that treatments are tailored to their individual needs.