We thank the authors for the letter and comments regarding our article. We agree that traumatic neuroma development involves simultaneous nerve repair and defensive mechanisms (i.e. reactive proliferation of perineurial cells) in the region of concomitant wound and scar contraction. We also agree that the treatment strategy was recommended to be targeted towards disruption of the proposed “easily violable balance between nerve regeneration and damage” to obtain a long-term treatment effect.
The clinical presentation of traumatic neuroma may vary. According to Herndon et al, as many as 30% of all neuromas are painful, which is the most frequent symptom . Other sensory anomalies is paresthesias, anaesthesia or hyperpathia. Treatment of this disorder is unnecessary unless the patient has severe pain .
Several types of treatment, both surgical and nonsurgical, have been advocated for painful traumatic neuromas. The techniques of centrocentral coaptation via an interpositional nerve graft or nerve stump transposition into muscle tissue and veins have been commonly used and promising results have been obtained .
In this case, the patient complained of numbness and had no pain and most of all, the patient did not agree to complete removal of the tumor with the nerve and subsequent nerve transplantation, we, therefore, just removed part of the neuroma.
In future, if the patient has severe pain or the neuroma development will progress, we will suggest the patient remove the whole neuroma and graft the nerve or nerve stump transposition into vein, to prevent ingrowth of scar tissue into close proximity of sutured nerve stumps.