The use of roll vein graft in treatment of neuroma in continuity in sensory nerves

A neuroma-in-continuity is a neuroma that results from failure of the regenerating nerve growth cone to reach peripheral targets and remain lost in the extraepineural environment. This is attributed to scar tissue formation which occurs at the site of nerve transection. The supporting structure of the nerve may be preserved. The nerve no longer functions properly. There may be local tenderness, disabling pain, hyperesthesia of the overlying dermatome and functional impairment. Neuroma formation is a major problem in nerve surgery and consensus about its treatment has not been reached. One of well-established techniques for treatment of such condition is resection of the neuroma and repair with interpositional nerve graft which may restore some degree of nerve function. The major drawback of this technique is that it sacrifices the remaining viable axons present in neuromas in-continuity. Roll vein graft technique was used in this study in 11 patients with neuroma-in-continuity. Exploration and neurolysis were done with 3.5 X magnification. Vein graft was rolled around the neuroma site. Postoperative follow up has shown marked relief of symptoms as regards spontaneous pain and hyperesthesia. Results suggest the success and ease of this technique in treatment of neuroma-in-continuity