Flap coverage for post-traumatic nerve pain in the arm

14 patients with painful neuroma, skin hyperesthesia or neuralgic rest pain were followed up (mean 20 months) after excision of skin and scar, neurolysis and coverage with pedicled or free flaps. Painful neuroma had improved in 3 of 7 patients. Skin hyperesthesia had been eliminated in 8 of 11 patients, and had improved in 3. Neuralgic rest pain had been eliminated in 5 of 6 patients, and was partially relieved in one. It is concluded that painful neuroma in continuity is not relieved by flap coverage, whereas skin hyperesthesia and neuralgic rest pain are appropriate for this type of treatment.