Painful traumatic neuroma formed in chronic osteomyelitis surgical scar treated by pulsed radiofrequency ablation

Abstract

Traumatic neuromas are sometimes formed in the surgical scars. Peripheral nerve injuries lead to complex clinical presentation. They are benign tumors which are formed by critical nerve tissue interaction and are extremely painful. They are formed by intraneural or extraneural scar formation affecting the nerve-gliding plane. Their main clinical presentation is neuropathic pain. This condition is also termed as “painful scar neuropathy.” There have been different approaches to treatment depending on the type of lesion whether it is perineural, endoneurial, or combined and type of pain due to traction or trauma, rest pain, and severity. Varying degrees of therapeutic success has been described in literature using different techniques. There is no consensus on the best therapeutic approach to treat neuropathic pain due to scar tethering. Patient counseling about the condition and the need for multiple interventions, if needed, is essential. Here, we report a case of a 16-year-old female with traumatic neuroma of superficial peroneal nerve formed in the surgical scar of chronic osteomyelitis presenting with severe pain and paresthesia treated by pulsed radio frequency (PRF). PRF is a novel therapeutic method to treat many conditions in pain medicine as it offers treatment without motor deficits and deafferentation syndrome.

Keywords

• benign tumor
• neuroma
• osteomyelitis
• paresthesia
• scar