Outcomes of surgically treated traumatic neuromas of cutaneous nerves as complications of ankle arthroscopy: A 5-year follow-up.

Abstract

To investigate the long term result of traumatic neuromas as complications of ankle arthroscopy treated by neuroma resection. Twenty-five patients diagnosed with traumatic neuroma as complications of ankle arthroscopy were included. The standard procedure of microsurgical neuroma resection and nerve release was performed in all patients. Outcomes comparison was evaluated at 3 months, 1 year, 2 years and 5 years postoperatively. Sensory function was assessed using the British Medical Research Council (BMRC) scale. Visual analog scale (VAS) was used to evaluate pain relief. The diameter of the affected nerve was measured by ultrasound. A total of 4 (16%) patients experienced neuroma recurrence during the 5-year follow-up. In nonrecurrence cases, sensory function improvement was observed at 3 months (P ​< ​0.0001) and 2 years (P ​= ​0.003). There was no further statistically significant improvement to 5 years, by which time 11 patients (52.4%) had above partial recovery of sensory function (S3+, S4). The VAS pain score was 4 (3-4) preoperatively and 2 (1-2) at 3 months (Z ​= ​-4.347, P ​< ​0.0001), which continued to improve, and patients got pain relief during the 2-5 years postoperative [2-5 years, 1 (0-1)]. The mean nerve diameter decreased at 3 months [preoperative, 20 (18.5-22); 3 months, 11 (9-12); Z ​= ​-6.082, P ​< ​0.0001]. We did not observe a statistically significant increase of nerve diameter during the rest of follow-up time [5 years, 10 (9-11); Z ​= ​-0.765, P ​= ​0.451]. Microsurgical resection was effective for traumatic neuromas of ankle cutaneous nerves. Patients experienced pain relief and partial recovery of nerve function. Most sensory recovery occurred during the first 3 months and continued to 2 years. However, neuroma recurrence was also observed in some cases. Ⅳ.