Management of digital neuromas: an update on current nonoperative and operative interventions

Digital neuromas can be psychologically and functionally debilitating. While typically the result of penetrating traumatic injury, neuromas also stem from blunt trauma, chronic irritation, or prior inadequate repair. Abnormal axonal regeneration without an appropriate distal target following nerve injury results in the formation of end-neuromas, often leading to significant pain. Conservative management is centered around a combination of pharmacological interventions and therapeutic modalities. In the setting of failed conservative management, surgical intervention is employed with the goals of excising the neuroma and redirecting axonal growth into healthy tissue. This article focuses on painful digital neuromas and options for both nonoperative and operative management.