Purpose: Symptomatic neuromas post traumatic digital amputation are common and challenging to manage. Management options are difficult as there is no distal target for nerve repair. Options include neuroma excision with nerve stump relocation stump in bone, proximal muscle, or fat. Dermal regenerative peripheral nerve interfaces (RPNI) have shown promising results in animal models providing an intuitive reinnervation site for sensory nerve stumps. METHOD: A 50-year-old right-handed female presented with a non-replantable distal middle finger amputation caused by a breadknife injury and underwent terminalisation of the digit at the level of her distal interphalangeal joint. 6-months later, she experienced significant pain over her ulnar digital nerve distribution. MRI and US showed a hypoechoic nodule proximal to the amputation site, suggestive of a neuroma. The patient underwent surgical exploration of bilateral neurovascular bundles for neuroma management. RESULTS: neuromas from the ulnar digital and radial digital nerves were identified and resected back to normal proximal nerves. Dermal fat graft harvested from the forearm was used to wrap each digital nerve and create a dermal RPNI. Within a week after surgery, the patient experienced a significant reduction in neuropathic pain. She was referred for hand therapy for desensitization and scar massage. At the 6-week follow-up, she reported no neuroma-related symptoms and a significantly improved quality of life. CONCLUSION: This case demonstrates a successful novel approach to digital neuroma management. We aim to raise awareness among hand surgeons about this technique and include it in the repertoire of neuroma management in distal fingertip amputations.