Long-term outcomes of symptomatic neuromas in the wrist, hand, and digits: A prospective cohort study

INTRODUCTION: Symptomatic neuromas of the hand and wrist are challenging to treat. We evaluated outcomes following traditional passive surgical techniques for neuromas in the hand, wrist, and digits by examining revision surgery rates, pain outcomes, and patient satisfaction. METHODS: In this multicenter prospective cohort study conducted in the Netherlands, patients who underwent surgery for symptomatic hand and wrist neuromas were analyzed. The primary outcome was revision surgery rate over long-term follow-up. The secondary outcomes included visual analogue scale (VAS, 0-100) pain scores (at rest during loading), achievement of minimally clinically important difference (MCID), function scores (VAS, 0-100), and patient satisfaction, all within 12-months postoperatively. Outcomes were compared between digital and hand-wrist neuroma locations. RESULTS: In 63 patients (83 neuromas), 27% underwent revision surgery with median time to revision of 1.3 years (IQR: 0.7-4.0 years) (median follow-up: 8.4 (IQR: 6.5-10.9) years). VAS pain at rest improved from 48 (95% confidence interval (CI): 42-55) to 25 (15-35) at 12 months (p