Purpose: We tested the null hypothesis that no factors are independently associated with the development of symptomatic neuroma after traumatic digital amputation.
Methods: We performed a retrospective review of 1,083 patients who underwent revision amputation for traumatic digital amputation; we excluded those undergoing replantation or revascularization. Patients who developed a painful neuroma during follow-up were identified with a minimum follow-up of 1 week and a median of 3.3 months. We calculated the rate of developing a painful neuroma as a proportion of the total number of patients and performed multivariable logistic regression analysis to identify factors independently associated with its development.
Results: Of 1,083 patients, 71 (6.6%) developed a symptomatic neuroma. Mean time to diagnosis was 6.4 months. A total of 47 patients (66%) underwent surgery for painful neuroma. Mean time to surgical intervention was 11 months. Index finger injury and avulsion injury mechanism were significantly associated with a higher risk for symptomatic neuroma.
Conclusions: Approximately 1 in 15 patients will develop a symptomatic neuroma after traumatic digital amputation and more than half of these patients will undergo revision surgery for neuroma, with a mean time to operative intervention of 11 months.
Type of study/level of evidence: Prognostic II.
Keywords: Digital amputation; incidence; neuroma; revision amputation; traumatic amputation.
Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.