Neuroma-in-continuity

A scarred, thickened segment of an injured nerve that remains in anatomical continuity, in which regenerating axons are trapped in fibrous tissue and a variable number cross to the distal stump. Whether to neurolyse it or to resect and graft it is decided by time, examination and intraoperative nerve action potential recording, because no pre-operative test grades it reliably.

Related terms

• Glossary

  Sunderland classification

  Sunderland's 1951 five-degree classification of nerve injury by the connective-tissue layer lost: first degree (neurapraxia), second (axon only, endoneurium intact — full recovery), third (endoneurium disrupted — partial recovery), fourth (perineurium disrupted — usually needs surgery) and fifth (complete transection). Mackinnon and Dellon added a sixth degree for mixed injuries.

• Treatment

  Nerve graft

  A segment of expendable sensory nerve, most often the sural or an upper-limb cutaneous nerve, interposed as one or several reversed cables to bridge a gap that cannot be closed without tension. Millesi's interfascicular grafting showed it beats suture under tension; it remains the standard for motor or mixed nerves, proximal injuries and gaps over 3 cm, at the cost of donor numbness and a second coaptation.

Articles mentioning this term

1. FESSH preparation · 26 September 2026

   Peripheral nerve injury and repair

   Peripheral nerve injury for FESSH candidates: degeneration, Seddon and Sunderland grades, electrodiagnosis, timing, grafts, conduits and nerve transfers.

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