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Targeted Muscle Reinnervation Can Reduce Phantom Limb Pain

Authors report reduction in pain and no symptomatic neuromas in 22 below-the-knee amputees

THURSDAY, Dec. 27, 2018 (HealthDay News) — Use of primary targeted muscle reinnervation (TMR) can prevent or reduce pain in below-the-knee amputees, according to a report published online Dec. 27 in Plastic and Reconstructive Surgery.

Noting that losing a limb can result in phantom limb and stump pain in more than 75 percent of amputees, Ian Valerio, M.D., from The Ohio State University College of Medicine in Columbus, and J. Byers Bowen, M.D., of Norfolk Plastic Surgery in Virginia, describe the use of primary TMR in below-the-knee amputees and explore the benefits of the procedure for preventing pain.

The researchers described 22 TMR surgeries performed over the course of three years on below-the-knee amputees: 18 primary and four secondary. No patients developed symptomatic neuromas. Of the primary TMR cohort, 72, 19, and 13 percent experienced phantom limb pain in the first month and at three and six months, respectively.

“A significant amount of pain in amputees is caused by disorganized nerve endings, i.e., symptomatic neuromas, in the residual limb. They form when nerves are severed and not addressed, thus they have nowhere to go,” Valerio said in a statement. “Attaching those cut nerve endings to motor nerves in a nearby muscle allows the body to re-establish its neural circuitry. This alleviates phantom and residual limb pain by giving those severed nerves somewhere to go and something to do.”

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