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Traumatic Versus Nontraumatic Hand Digit Amputations: Neuroma Risk, Prevention Success, and Predictive Factors.
Mehmet Furkan Tunaboylu1, Sai Cherukuri1, Ali Gharibi Loron2
1Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN.
The Journal of Hand Surgery
|March 26, 2025
Summary
Elective and emergent digital amputations showed similar neuroma rates. Factors like proximal amputations and alcohol use predict persistent stump pain, guiding future surgical interventions.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Pain Management
Background:
- Digital amputations are common following trauma.
- Neuromas and persistent stump pain are significant complications.
Purpose of the Study:
- To compare neuroma rates in elective versus emergent digital amputations.
- To identify factors contributing to persistent pain after amputation.
Main Methods:
- Retrospective review of 1,171 digital amputations (2015-2023).
- Analysis of demographic data, comorbidities, surgical details, and pain outcomes.
- Study level of evidence: Prognostic IV.
Main Results:
- Comparable symptomatic neuroma rates: 4% (elective) vs. 3.2% (emergent).
- Factors associated with pain included proximal amputations, alcohol abuse, inflammatory conditions, and blast injuries.
- 32 of 111 patients with severe stump pain were diagnosed with neuromas.
Conclusions:
- Elective and emergent digital amputations have similar neuroma rates.
- Proximal amputations, alcohol use, inflammatory arthritis, and blast injuries predict post-amputation pain.
- These findings may inform prophylactic surgical strategies like targeted muscle reinnervation.
