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Titolo:
Retrospective review of eighteen patients who underwent transtibial amputation for intractable pain
Autore:
Honkamp, N; Amendola, A; Hurwitz, S; Saltzman, CL;
Indirizzi:
Univ Iowa, Dept Orthopaed Surg, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242 Orthopaed Surg, Iowa City, IA 52242 USA Univ Virginia, Dept Orthopaed Surg, Charlottesville, VA 22908 USA Univ Virginia Charlottesville VA USA 22908 Charlottesville, VA 22908 USA Univ Western Ontario, London, ON, Canada Univ Western Ontario London ON Canada estern Ontario, London, ON, Canada
Titolo Testata:
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
fascicolo: 10, volume: 83A, anno: 2001,
pagine: 1479 - 1483
SICI:
0021-9355(200110)83A:10<1479:RROEPW>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
FOOT FUNCTION INDEX; PHANTOM PAIN; STUMP PAIN; AMPUTEES; SENSATIONS; HISTORY; LIMBS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Honkamp, N Univ Iowa, Dept Orthopaed Surg, 200 Hawkins Dr, Iowa City, IA 52242 USA Univ Iowa 200 Hawkins Dr Iowa City IA USA 52242 y, IA 52242 USA
Citazione:
N. Honkamp et al., "Retrospective review of eighteen patients who underwent transtibial amputation for intractable pain", J BONE-AM V, 83A(10), 2001, pp. 1479-1483

Abstract

Background: Amputations are rarely performed solely for pain relief because of concerns regarding the persistence of pain and disability after the procedure. The purpose of this study was to assess the outcome of below-the-knee amputations performed to relieve intractable foot and ankle pain. Methods: A chart review was conducted to identify all below-the-knee amputations that had been performed for the treatment of chronic foot and ankle pain by three orthopaedic foot and ankle specialists at three institutions. The inclusion criteria included (1) intractable foot or ankle pain as the surgical indication, (2) failure of maximal medical therapy, (3) failure ofprior surgical reconstruction, and (4) a minimum follow-up period of twenty-four months after below-the-knee amputation. Patients with diabetes mellitus, peripheral vascular occlusive disease or peripheral neuropathy were excluded. Each participant completed a two-part questionnaire with regard to the levels of disability, function, pain, and recreational activity both before and after the amputation. Results: Twenty patients met the inclusion criteria, and eighteen completed the study. The study group included four women and fourteen men who had an average age of forty-two years (range, twenty-six to sixty-one years) andwere followed for an average of forty-one months (range, twenty-five to eighty-five months) after the amputation. When asked whether they would have the below-the-knee amputation done again under similar circumstances, sixteen patients said yes, one was unsure, and one said no. The same distribution was observed when the patients were asked whether they were satisfied with the outcome: sixteen said yes, one was unsure, and one said no. Disability, pain, and recreational status were assessed with a 10-cm visual analog scale. After the amputation, the patients reported a decrease in both pain frequency (with the average score improving from 9.8 to 1.7; p < 0.0001) andpain intensity (with the average score improving from 8.4 to 2.6; p < 0.0001). Ten patients discontinued the use of narcotics, and seven decreased the level and/or dosage. Three patients worked before the amputation, and eight worked after the amputation. The average walking distance increased from0.3 to 0.8 mile (p = 0.0034). Conclusion: In selected patients, a below-the-knee amputation may be a good salvage procedure for intractable foot and ankle pain that is unresponsive to all medical and local surgical reconstructive techniques.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 12:54:40