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Novel Approaches to Reduce Symptomatic Neuroma Pain After Limb Amputation

  • Amputation Rehabilitation (J Heckman, Section Editor)
  • Published:
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Abstract

Purpose of Review

A considerable number of major limb amputation patients will develop symptomatic neuromas within the residual limb. There has been a paradigm shift in the surgical treatment of symptomatic neuromas from techniques that attempt to interrupt axonal regeneration in favor of techniques that permit reinnervation. In addition, growing evidence suggests that successful treatment of peripheral nerve pain may diminish the development of phantom limb pain. We discuss novel surgical techniques that seek to prevent neuroma formation and in turn reduce phantom limb pain.

Recent Findings

Targeted muscle reinnervation and regenerative peripheral nerve interface surgery provide regenerating peripheral nerves denervated targets for reinnervation thus reducing the number of free axons available to form neuromas. While very different in technique, both approaches decrease the formation of symptomatic neuromas. In doing so, these methods reduce the experience of residual limb pain and phantom limb pain.

Summary

Implementation of innovative surgical techniques after peripheral nerve transection can transform the management of postamputation pain. Decreasing the impact of neuroma pain and phantom limb pain will facilitate prosthetic rehabilitation, decrease analgesic use, and improve quality of life after limb amputation.

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  1. Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI, 48109, USA

    Sarah E. Hart & Theodore A. Kung

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  1. Sarah E. Hart
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Hart, S.E., Kung, T.A. Novel Approaches to Reduce Symptomatic Neuroma Pain After Limb Amputation. Curr Phys Med Rehabil Rep 8, 83–91 (2020). https://doi.org/10.1007/s40141-020-00276-2

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