Centro-Central Union for the Prevention of Neuroma Formation after Finger Amputation

Belcher, H. J. C. R.; Pandya, Aditya

doi:10.1054/jhsb.2000.0372

Cited by 43 publications

(20 citation statements)

References 15 publications

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“…17 Other options described include crushing the distal nerve stump, 18 burying the nerve stump within a cortical window cut into a nearby bone, 19 and sewing two distal nerve stumps directly together into a loop. 20 Despite numerous methods and advances, none have proven consistent enough to set a standard of management for both preventing and treating NPLP in amputee populations. During this millennium, however, researchers continue to make significant advancements in understanding and treating symptomatic NPLP.…”

Section: Treatment Optionsmentioning

confidence: 99%

Targeted Muscle Reinnervation to Improve Pain, Prosthetic Tolerance, and Bioprosthetic Outcomes in the Amputee

Bowen

Wee

Kalik

et al. 2017

Advances in Wound Care

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There are ∼185,000 amputations each year and nearly 2 million amputees currently living in the United States. Approximately 25% of these amputees will experience chronic pain issues secondary to localized neuroma pain and/or phantom limb pain. The significant discomfort caused by neuroma and phantom limb pain interferes with prosthesis wear, subjecting amputees to the additional physical and psychological morbidity associated with chronic immobility. Although numerous neuroma treatments are described, none of these methods are consistently effective in eliminating symptoms. Targeted muscle reinnervation (TMR) is a surgical technique involving the transfer of residual peripheral nerves to redundant target muscle motor nerves, restoring physiological continuity and encouraging organized nerve regeneration to decrease and potentially prevent the chaotic and misdirected nerve growth, which can contribute to pain experienced within the residual limb. TMR represents one of the more promising treatments for neuroma pain. Prior research into "secondary" TMR performed in a delayed manner after amputation has shown great improvement in treating amputee pain issues because of peripheral nerve dysfunction. "Primary" TMR performed at the time of amputation suggests that it may prevent neuroma formation while avoiding the risks associated with a delayed procedure. In addition, TMR permits the target muscles to act as bioamplifiers to direct bioprosthetic control and function. TMR has the potential to treat pain from neuromas while enabling amputee patients to return to their activities of daily living and improve prosthetic use and tolerance. Recent research in the areas of secondary (, delayed) and primary TMR aims to optimize efficacy and efficiency and demonstrates great potential for establishing a new standard of care for amputees.

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Section: Treatment Optionsmentioning

confidence: 99%

Targeted Muscle Reinnervation to Improve Pain, Prosthetic Tolerance, and Bioprosthetic Outcomes in the Amputee

Bowen

Wee

Kalik

et al. 2017

Advances in Wound Care

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“…Traditionally, traction neurectomy is performed at the time of amputation; however this results in a neuroma as the transected axons attempt to regenerate . Numerous surgical techniques have been proposed including excision of the neuroma and burying the nerve in muscle, bone, or vein, and coaptation of two nerve ends . To date, no method provides consistently effective relief of neuroma‐related postamputation pain.…”

Section: Introductionmentioning

confidence: 99%

Targeted muscle reinnervation in oncologic amputees: Early experience of a novel institutional protocol

Alexander

Jordan

West

et al. 2019

Journal of Surgical Oncology

124

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Background We describe a multidisciplinary approach for comprehensive care of amputees with concurrent targeted muscle reinnervation (TMR) at the time of amputation. Methods Our TMR cohort was compared to a cross‐sectional sample of unselected oncologic amputees not treated at our institution (N = 58). Patient‐Reported Outcomes Measurement Information System (NRS, PROMIS) were used to assess postamputation pain. Results Thirty‐one patients underwent amputation with concurrent TMR during the study; 27 patients completed pain surveys; 15 had greater than 1 year follow‐up (mean follow‐up 14.7 months). Neuroma symptoms occurred significantly less frequently and with less intensity among the TMR cohort. Mean differences for PROMIS pain intensity, behavior, and interference for phantom limb pain (PLP) were 5.855 (95%CI 1.159‐10.55; P = .015), 5.896 (95%CI 0.492‐11.30; P = .033), and 7.435 (95%CI 1.797‐13.07; P = .011) respectively, with lower scores for TMR cohort. For residual limb pain, PROMIS pain intensity, behavior, and interference mean differences were 5.477 (95%CI 0.528‐10.42; P = .031), 6.195 (95%CI 0.705‐11.69; P = .028), and 6.816 (95%CI 1.438‐12.2; P = .014), respectively. Fifty‐six percent took opioids before amputation compared to 22% at 1 year postoperatively. Conclusions Multidisciplinary care of amputees including concurrent amputation and TMR, multimodal postoperative pain management, amputee‐centered rehabilitation, and peer support demonstrates reduced incidence and severity of neuroma and PLP.

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“…Failure of the noninvasive method should be followed with surgical resection of the tumor with proximal nerve relocation into bone, muscle, vein, or nerve to prevent further recurrence of symptoms. Surgical treatment should correct 75% or more of the remaining cases 182–184 …”

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confidence: 99%

Soft Tissue Tumors of the Hand. 1. Benign

Sobanko¹,

Dagum²,

Davis³

et al. 2007

Dermatol Surg

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Soft tissue tumors of the hand arise from skin, subcutaneous tissue, tendons, nerve, and blood vessels. Many of these lesions occur on other parts of the body; however, the hand remains a unique site because these tumors have symptoms, appearances, treatments, and prognoses that may be quite different than when on other parts of the body. Their characteristics and the severity of symptoms vary markedly depending on the exact location, size, and type of tumor-and many of these tumors can have multiple forms of presentation. Two articles are intended to provide an overview of benign (this article) and malignant tumors (subsequent issue) of the hand. The rarer and more deleterious tumors are discussed in detail while the common tumors and epidermal lesions with which practitioners are familiar are briefly overviewed. At the completion of these review articles, participants should be able to identify and diagnose various benign and malignant hand tumors as well as understand the accepted current treatment of these growths.

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Centro-Central Union for the Prevention of Neuroma Formation after Finger Amputation

Cited by 43 publications

References 15 publications

Targeted Muscle Reinnervation to Improve Pain, Prosthetic Tolerance, and Bioprosthetic Outcomes in the Amputee

Targeted Muscle Reinnervation to Improve Pain, Prosthetic Tolerance, and Bioprosthetic Outcomes in the Amputee

Targeted muscle reinnervation in oncologic amputees: Early experience of a novel institutional protocol

Soft Tissue Tumors of the Hand. 1. Benign

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