TUMOES 101 



Describe a false neuroma. 



It is a pea to thumb size, somewhat movable, bard, pain- 

 ful new-growtb of comparatively slow development, usually 

 met witb at tbe proximal end of a divided nerve. 



What are the causes of false neuromata ? 



Tbey follow almost invariably neurectomies, and are due- 

 to stretching the nerve before cutting it, or severing the 

 nerve below the upper wound commissure, thus allowing its 

 proximal end to project out of the upper wound commissure. 

 This exposes the connective tissue of the nerve sheath to irri- 

 tating influences, invariably seen in wounds healing by second, 

 intention — that is, those with pus formation, as a result of 

 which connective tissue proliferation, expressed by a bulbous- 

 thickening of the proximal nerve end, takes place. 



Name the seats of predilection. 



After neurectomies they are found at the proximal end of 

 the median, plantar and tibial nerves. 



Outline the treatment of neurofibromata. 



Dissect it loose from the surrounding tissue and am- 

 putate. 

 Are they likely to recur ? 



The amputated tumor never recurs, but since a new neu- 

 rectomy has to be performed to amputate the new-growth, a 

 new fibroneuroma may start from the recent proximal nerve- 

 stump. 

 Are neurofibromata of practical interest ? 



Decidedly so, as they cause lameness. They are very 

 often met with, and will continue to be met with frequently, 

 as long as the surgeon does not operate lege ariis— that is, he 

 must not stretch the nerve, dig around and mutilate the tis- 



