Informed Decision-Making Regarding Amputation for Complex Regional Pain Syndrome Type I.

Area of Science:

• Pain Medicine
• Surgical Decision-Making
• Patient Outcomes

Background:

• Literature on amputation decisions for complex regional pain syndrome type I (CRPS-I) is limited.
• This study addresses the scarcity of information regarding amputation for CRPS-I.

Purpose of the Study:

• To evaluate the informed decision-making process for amputation in patients with CRPS-I.
• To analyze the factors influencing amputation decisions and the subsequent outcomes.

Main Methods:

• Retrospective study of 36 patients who underwent amputation for CRPS-I between 2000 and 2012.
• Data collected on preceding incidents, reasons for amputation, amputation levels, and post-operative outcomes.
• Therapeutic Level IV evidence.

Main Results:

• Amputation decisions were made collaboratively between the medical team and the patient.
• Factors considered included pain levels, infection, residual limb goals, physical function, and psychological flags.
• No intraoperative complications; 22% postoperative infection rate. High incidence of phantom pain (72% within 3 months, 77% after 1 year).

Conclusions:

• Informed decision-making for CRPS-I amputation is complex, with unpredictable patient-specific outcomes.
• Amputation should be considered a treatment option for long-standing, therapy-resistant CRPS-I.