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Feasibility for Immediate Targeted Muscle Reinnervation Based on Lower Extremity Amputations Trends
Alexa De la Fuente Hagopian1, Souha Farhat1, Andres F Doval1
1The Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Tex.
Plastic and Reconstructive Surgery. Global Open
|April 19, 2023
Summary
Routine immediate targeted muscle reinnervation (TMR) is practical for lower extremity amputations. Most amputations occur during standard work hours, allowing TMR to be scheduled concurrently, improving patient care and preventing phantom limb pain.
Area of Science:
- Surgical Procedures
- Amputation Management
- Pain Management
Background:
- Targeted muscle reinnervation (TMR) manages phantom limb pain and neuroma after lower extremity amputation.
- Scheduling conflicts arise when TMR is performed by different surgeons than those performing the amputation.
Purpose of the Study:
- To analyze historical scheduling trends for lower extremity amputations.
- To evaluate the practicality of offering routine immediate TMR concurrently with amputation.
Main Methods:
- Retrospective analysis of de-identified data over five years for lower extremity amputations.
- Data included amputation specialty, weekly distribution, and case timing.
Main Results:
- 1549 lower extremity amputations were performed, evenly distributed throughout the year and week.
- Vascular, orthopedic, and general surgery were the top specialties.
- Most amputations (96.4%) started between 6 am and 6 pm.
Conclusions:
- Lower extremity amputations in a large, nontrauma system occur during typical working hours.
- This timing supports the feasibility of concurrent TMR with amputation.
- Optimizing scheduling can improve patient outcomes and streamline care.
