Peripheral Nerve Management in Extremity Amputations

John T Richards¹, Michael D Baird², Scott M Tintle², Jason M Souza³, Christopher H Renninger⁴, Benjamin K Potter²

Affiliations

¹ Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: john.richards@som.umaryland.edu.
² Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
³ Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁴ Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

PMID: 35365260
DOI: 10.1016/j.ocl.2022.01.002

Review

Peripheral Nerve Management in Extremity Amputations

John T Richards et al. Orthop Clin North Am. 2022 Apr.

. 2022 Apr;53(2):155-166.

doi: 10.1016/j.ocl.2022.01.002. Epub 2022 Mar 8.

Authors

John T Richards¹, Michael D Baird², Scott M Tintle², Jason M Souza³, Christopher H Renninger⁴, Benjamin K Potter²

Affiliations

¹ Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: john.richards@som.umaryland.edu.
² Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
³ Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁴ Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.

PMID: 35365260
DOI: 10.1016/j.ocl.2022.01.002

Abstract

The effective management of peripheral nerves in amputation surgery is critical to optimizing patient outcomes. Nerve-related pain after amputation is common, maybe a source of dissatisfaction and functional impairment, and should be considered in all amputees presenting with pain and dysfunction. While traction neurectomy or transposition has long been the standard of care, both regenerative peripheral nerve interface (RPNI) and targeted muscle reinnervation (TMR) have emerged as promising techniques to improve neuroma-related and phantom pain. A multi-disciplinary and multi-modal approach is essential for the optimal management of amputees both acutely and in the delayed or chronic setting.

Keywords: Amputation; Nerve injury; Neuroma; Phantom limb pain; Regenerative peripheral nerve interface; Targeted muscle reinnervation.

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Disclosure All authors report no disclosures or conflict of interest.

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Peripheral Nerve Management in Extremity Amputations

Affiliations

Peripheral Nerve Management in Extremity Amputations

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources