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Targeted Muscle Reinnervation in the upper extremity for reduction of pain following amputation, an analysis review on reported outcomes
Grey Fortenbery, Kyle Lineberry
Case Western Reserve- University Hospitals
2021-02-15
Presenter: Grey Fortenbery
Affidavit:
Material has not been previously published.
Director Name: Edward Davidson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background:
Major limb amputations are relatively common in the US with an estimated 1.6 million people living with amputation with 41,000 of them with amputations of the upper extremity in 2005, with the number expected to climb. Chronic pain, either from phantom limb, residual, or neuroma pain is common after amputation affects upwards of 80% of amputees. Targeted muscle reinnervation (TMR), a technique initially developed to enhance prosthesis control, has shown promise of reducing pain from amputations.
Methods:
A review of literature was conducted using PubMed search using a combination of terms "upper extremity" "hand" "pain" and "targeted muscle reinnervation."
Results:
Six articles were selected for complete review. One of the six articles was excluded due to combination of lower and upper extremity results. Of the 5 articles selected, 2 were retrospective reviews and 3 were case reports. A total of 46 patients were included in these reported studies. Four of the five articles examined reduction of neuroma pain, whereas 1 article examined reduction of residual and phantom limb pain. 30 patients were examined for neuroma pain reduction with 100% noting reduction in pain. 16 patients were included in RLP and PLP reduction study with 62.4% (10/16) reporting no PLP and 50% (8/16) reporting no RLP.
Conclusion:
Much of the current literature is limited to retrospective reviews and case studies with a low patient count; however, the data from these show reduction in residual and phantom limb pain and resolution of neuroma type pain
