December 1946


Author Affiliations

From the Department of Surgery of the Presbyterian Hospital, and the Laboratory of Surgical Pathology, Columbia University College of Physicians and Surgeons.

Arch Surg. 1946;53(6):646-651. doi:10.1001/archsurg.1946.01230060657004

THE CAUSE of painful and traumatic neuromas is not clearly understood. The investigation reported in this paper has been undertaken with the hope of determining whether or not the various methods of dealing with the divided nerve ends influence their occurrence or prevention. The records of the Laboratory of Surgical Pathology have been examined for proved cases, and these as well as amputations of major extremities in the Presbyterian Hospital from 1932 to 1945 were reviewed. Only records with adequate follow-up were used.

DEFINITION  After section, the distal end of the nerve may enlarge and simulate a tumor. These enlargements, called neuromas, are not true neoplasms. The nodule is made up of granulation tissue through which many strands of regenerated or proliferated axons with Schwann sheaths pass. These are arranged in interlacing bundles running in all directions. It is believed that the granulation tissue preceding neuroma formation arises from the

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