A Technique for the Treatment of Neuroma In-Continuity

A surgical technique for the management of a neuroma in-continuity, in which motor function is preserved and sensory function is reconstructed with nerve grafting, is presented. Tedious and potentially damaging dissection within the neuroma in-continuity is avoided. The functioning motor fascicles are identified proximal and distal to the injury site with electrical nerve stimulation eliciting muscle contraction. These motor fascicles are preserved. The electrically silent and nonfunctioning sensory fascicles are divided proximal and distal to the neuroma and reconstructed with autogenous nerve grafts. These nerve grafts bypass the functioning motor portion of the neuroma in-continuity.