[The relationship between phantom limb pain and neuroma].

OBJECTIVES

We evaluated the effect of exploratory neurectomy on phantom limb pain (PLP) in patients who had PLP and neuroma findings in the amputated extremity.

METHODS

The study included 14 patients (13 males, 1 female; mean age 30 years; range 21 to 54 years) who developed symptomatic neurinoma and PLP following amputation of an extremity due to trauma (9 mine blasts, 5 traffic accidents). Postamputation period ranged from 2.5 to 17 years (mean 5.5 years). All the patients had PLP of varying intensity and neuroma symptoms causing the sensation of a small electric shock, aroused by application of prosthesis, contact with bed, or on palpation. The mean visual analog scale (VAS) score for PLP was 8.4 (range 7 to 10) before neurectomy. The mean follow-up was 71.5 months (range 44 to 98 months).

RESULTS

Complete recovery from PLP was achieved after neurectomy. Symptoms of neuroma completely disappeared during the follow-up period. Visual analog scale score was 0 in all the patients.

CONCLUSION

The best way to prevent postamputation neuromas and PLP is to cut the nerve as proximal as possible, allowing its retraction into the soft tissue, and leaving its end away from the stump.