fig7

Figure 7. Examples of the use of RPNI both to prevent and treat neuroma-related pain. Upper images of patient undergoing elective amputation of his right index finger. A: Dorsal and volar digital nerve stumps. B: Muscle grafts from remnants of intrinsic muscles used to create RPNI units, which are buried deep in the adjacent intrinsic muscles. At 3 years postoperatively, the patient had no painful neuromas. Lower images of patient with painful neuroma of the middle finger. C: neuroma (indicated by arrow) prior to excision. D: Excised neuroma prior to RPNI of the free end of the nerve. The patient had no further neuroma-related symptoms at 12 months follow-up.