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The Painful Residual Limb: Treatment Strategies

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Comprehensive Management of the Upper-Limb Amputee

Abstract

The upper-extremity amputee suffers a significant functional loss secondary to impairment of muscle power, sensory feedback, proprioception, and specific activities such as prehension. Pain often occurs without design or expectation, thereby compounding the frustration and depression of the patient and inhibiting rehabilitation.1 The acute effect of the psychological trauma of the amputation can lead to a distorted and painful body image, and the patient and his or her family should be properly prepared and reassured by the surgeon before the amputation.

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References

  1. Orner GE Jr: Nerve, neuroma, and pain problems related to upper limb amputations. Orthop Clin North Am 1981; 12:751.

    Google Scholar 

  2. Omer GE Jr: Management of the painful extremity. Curr Pract Orthop Surg 1979; 8:86.

    PubMed  CAS  Google Scholar 

  3. Parkes CM, Napier MM: Psychiatric sequelae of amputation. Br J Psychiatry Spec Publ 1975; 9:440.

    Google Scholar 

  4. Henderson JH, Eaton RG, Littler TW: Management of painful neuromas in the hand. J Bone Joint Surg 1976; 58A:369.

    Google Scholar 

  5. Carlen PL, Wall PD, Nadvorna H, et al: Phantom limbs and related phenomena in recent traumatic amputations. Neurology 1978; 28:211–217.

    PubMed  CAS  Google Scholar 

  6. Ridings J: Phantom limb: Some theories. Anesthesia 1976; 31:102.

    Article  Google Scholar 

  7. Frazier SH, Kolb LC: Psychiatric aspects of pain and the phantom limb. Orthop Clin North Am 1970; 1:481.

    PubMed  CAS  Google Scholar 

  8. Melzack R: The Puzzle of Pain. New York, Basic Books Inc, 1973.

    Google Scholar 

  9. Melzack R: Central neural mechanisms in phantom limb pain, in Bonica JJ (ed): Adv Neurol 1976; 4:319–326.

    Google Scholar 

  10. Sherman R, Sherman C, Gall N: A survey of current phantom limb pain treatment in the United States. Pain 1980; 8:85–99.

    Article  PubMed  CAS  Google Scholar 

  11. Gildenberg PL: Central surgical procedures for pain of peripheral nerve. Origin in Omer GE Jr, Spinner M (eds): Management of Peripheral Nerve Problems. Philadelphia, WB Saunders Co, 1980.

    Google Scholar 

  12. Richardson DE: Deep brain stimulation for pain relief. Neurosurgery New York, McGraw-Hill, 1985.

    Google Scholar 

  13. Lankford LL: Reflex sympathetic dystrophy. Omer GE Jr, Spinner M (eds): Management of Peripheral Nerve Problems. Philadelphia, WB Saunders Co, 1980.

    Google Scholar 

  14. Flat AE: Digital artery sympathectomy. J Hand Surg 1980; 5:550.

    Google Scholar 

  15. Smith JR, Gomez NH: Local injection therapy of neuromata of the hand with triamcinolone acetonide, a preliminary study of twenty two patients. J Bone Joint Surg 1970; 52A:71.

    Google Scholar 

  16. Gorkisch K, Boese-Landgraf J, Vaubel E: Treatment and prevention of amputation neuromas in hand surgery. Plast Reconstr Surg 1984; 73:293.

    Article  PubMed  CAS  Google Scholar 

  17. Goldstein SA, Sturim, HS: Intraosseous nerve transposition for treatment of painful neuromas. J Hand Surg [Am] 1985; 10A(2):270.

    Google Scholar 

  18. Dellon AL, Mackinnon SE, Pestronk A: Implantation of sensory nerve into muscle: Preliminary clinical and experimental observation on neuroma formation. Ann Plast Surg 1984; 12:30.

    Article  PubMed  CAS  Google Scholar 

  19. Reisman N, Dellon AL: The abductor digiti minimi muscle flap: A salvage technique for palmar wrist pain. Plast Reconstr Surg 1984; 72:859.

    Google Scholar 

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© 1989 Springer-Verlag New York Inc.

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Shenaq, S.M., Meier, R.H., Brotzman, B. (1989). The Painful Residual Limb: Treatment Strategies. In: Atkins, D.J., Meier, R.H. (eds) Comprehensive Management of the Upper-Limb Amputee. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3530-9_8

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  • DOI: https://doi.org/10.1007/978-1-4612-3530-9_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8143-6

  • Online ISBN: 978-1-4612-3530-9

  • eBook Packages: Springer Book Archive

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