Coaptation of cutaneous nerves for intractable stump pain and phantom limb pain after upper limb amputation: Strategies in trauma and limb reconstruction

Hideki Kadota, Kunihiro Ishida

研究成果: Contribution to journalArticle査読

抄録

Background: Various surgical treatments have been advocated for stump pain and phantom limb pain after limb amputation but the most effective is unknown. We report a case of intractable stump pain and phantom limb pain of the upper limb, which was successfully treated by end-to-end coaptation of the cutaneous nerves after multimodal treatment failures. Case description: A 39-year-old man was referred to our department with a history of severe stump neuroma-related pain and phantom limb pain of his right upper limb. He had undergone multiple treatments over 26 years including medication, nerve blocks, and repeated surgeries. None had been successful for relief of pain. The clinical assessment showed a point of marked tenderness around the medial stump of the upper arm. Ultrasound-guided peripheral infiltration of local anaesthetic around the medial stump produced significant relief of his pain. Exploration around the medial limb stump revealed two stump neuromas of the medial cutaneous nerves of the forearm. Both stump neuromas were resected, and their stumps were coapted to each other. After 4 years, he was completely relieved of his pain and without any sensory deficit. Conclusion: Successful nerve coaptations for painful stump neuromas of the upper limb are reported rarely. This case suggests this method can be helpful. The patient burden was minimal because it involved the resection and coaptation of the two neuromas. This method should be encouraged for cases of intractable stump-related pain in the upper limb.

本文言語英語
ページ(範囲)50-53
ページ数4
ジャーナルStrategies in Trauma and Limb Reconstruction
15
1
DOI
出版ステータス出版済み - 2020

All Science Journal Classification (ASJC) codes

  • 整形外科およびスポーツ医学

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