Complex regional pain syndrome of the residual limb in a transtibial lower-limb amputee: diagnosis and treatment

2021 ◽  
Vol 14 (7) ◽  
pp. e239650
Author(s):  
Christos Karatzios ◽  
Francois Luthi ◽  
Guillaume Muff ◽  
Charles Benaim
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Lower Limb ◽  
Pain Syndrome ◽  
Clinical Findings ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Intractable Pain ◽  
Residual Limb ◽  
Residual Limb Pain ◽  
Budapest Criteria

We present the unusual case of complex regional pain syndrome (CRPS) of the residual limb in a 54-year-old woman with transtibial lower-limb amputation. Intractable pain developed 14 months after amputation, followed by successful rehabilitation. Anamnesis and clinical findings included sensory symptoms, vasomotor symptoms and signs, and oedema. The Budapest criteria for a diagnosis of CRPS were met. After infusions of bisphosphonates during a 5-week inpatient interdisciplinary rehabilitation programme, the pain decreased. Clinicians should suspect CRPS in case of chronic or recurrent residual limb pain. The Budapest criteria seem applicable even if interpretation of symptoms and findings can be complicated in vascular polymorbid lower-limb amputation. Bisphosphonates, proposed as first-line pharmacological treatment, can be useful.

How Common Are Chronic Residual Limb Pain, Phantom Pain, and Back Pain More Than 20 Years After Lower Limb Amputation for Malignant Tumors?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kevin Döring ◽  
Carmen Trost ◽  
Christoph Hofer ◽  
Martin Salzer ◽  
Tryphon Kelaridis ◽  
...  
Keyword(s):  
Back Pain ◽  
Lower Limb ◽  
Malignant Tumors ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Residual Limb ◽  
Limb Pain ◽  
Residual Limb Pain

Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation

2000 ◽  
Vol 81 (8) ◽  
pp. 1039-1044 ◽  
Author(s):  
Dawn M. Ehde ◽  
Joseph M. Czerniecki ◽  
Douglas G. Smith ◽  
Kellye M. Campbell ◽  
W.Thomas Edwards ◽  
...  
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Residual Limb ◽  
Limb Pain ◽  
Residual Limb Pain

scholarly journals Pain and psychosocial adjustment to lower limb amputation amongst prosthesis users

2008 ◽  
Vol 32 (2) ◽  
pp. 244-252 ◽  
Author(s):  
Deirdre Desmond ◽  
Pamela Gallagher ◽  
David Henderson-Slater ◽  
Rob Chatfield
Keyword(s):  
Psychosocial Adjustment ◽  
Lower Limb ◽  
Postal Survey ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Residual Limb ◽  
Limb Pain ◽  
Activity Restriction ◽  
Residual Limb Pain

The aim of this study was to investigate associations between post-amputation phantom and residual limb pain and prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation among lower limb prosthesis users. Eighty-nine people with a lower limb amputation completed a postal survey. Characteristics of phantom and residual limb pain, prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation were assessed using the Trinity Amputation and Prosthesis Experience Scales (TAPES). Comparisons of those who experienced residual and/or phantom limb pain in the preceding assessment with those who did not revealed significant differences in prosthesis satisfaction, psychosocial adjustment but not in activity restriction. Overall, it is important for clinicians to ascertain the type and level of pain that the person is experiencing and to separate the experiences of the pain from the experiences of the prosthetic limb.

scholarly journals Obesity and Skin Problems in Persons With a Lower Limb Amputation: An Observational Study

2021 ◽  
Author(s):  
Terezka S. Mollee ◽  
Pieter U. Dijkstra ◽  
Rienk Dekker ◽  
Jan H.B. Geertzen
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Confidence Interval ◽  
Body Mass ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Residual Limb ◽  
Prevalence Of Obesity ◽  
The Impact

Abstract Background: A lower limb amputation can lead to weight gain and obesity. However, data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. Methods: A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects’ body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. Results: In total, 413 persons were enrolled. Of them, 39% (95% confidence interval 35%−44%) was overweight and 28% (95% confidence interval 24%−33%) was obese. A total of 77% (95% confidence interval 73%−81%) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0−8.9)). Conclusion: Our findings show that obesity is common in the ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.

scholarly journals The association between body mass index and skin problems in persons with a lower limb amputation: an observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Terezka S. Mollee ◽  
Pieter U. Dijkstra ◽  
Rienk Dekker ◽  
Jan H.B. Geertzen
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Confidence Interval ◽  
Body Mass ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Residual Limb ◽  
Prevalence Of Obesity ◽  
The Impact

Abstract Background Obesity is common in persons with a lower limb amputation, an amputation can also lead to further weight gain. Data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. Methods A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects’ body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. Results In total, 413 persons were enrolled. Of them, 39% (95 % confidence interval 35;44) were overweight and 28% (95% confidence interval 24;33) were obese. A total of 77% (95% confidence interval 73;81) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0;8.9)). Conclusions Our findings show that obesity is common in the Dutch ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.

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