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An algorithm for elective amputation combined with targeted muscle reinnervation in complex regional pain dyndrome: a perspective

Complex regional pain syndrome (CRPS) can result in a devastating condition. For a small number of patients, there is a non-response to any existing multimodal therapies and they ultimately request amputation. Such a drastic and final decision is not easy to take for both the patient and the surgeon...

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Main Authors: Aman, Martin (Author) , Biglari, Bahram (Author) , Thielen, Mirjam (Author) , Böcker, Arne Hendrik (Author) , Stolle, Annette M. (Author) , Schwarz, Daniel (Author) , Gazyakan, Emre (Author) , Kneser, Ulrich (Author) , Harhaus-Wähner, Leila (Author)
Format: Article (Journal)
Language:English
Published: 19 July 2022
In: International Journal of Person Centered Medicine
Year: 2022, Volume: 12, Issue: 7, Pages: 1-10
ISSN:2043-7749
DOI:10.3390/jpm12071169
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jpm12071169
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2075-4426/12/7/1169
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Author Notes:Martin Aman, Bahram Biglari, Mirjam Thielen, Arne H. Boecker, Annette Stolle, Daniel Schwarz, Emre Gazyakan, Ulrich Kneser and Leila Harhaus
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Summary:Complex regional pain syndrome (CRPS) can result in a devastating condition. For a small number of patients, there is a non-response to any existing multimodal therapies and they ultimately request amputation. Such a drastic and final decision is not easy to take for both the patient and the surgeon and requires careful and interdisciplinary assessments and considerations. Furthermore, new surgical procedures, such as targeted muscle reinnervation (TMR) and hybrid prosthetic fitting, and multidisciplinary board advice should be included when considering amputation. In order to help other therapeutic teams in decision making for such rare but more than demanding cases, we aimed to propose an advanced algorithm for amputation indications in CRPS patients combining all these new factors. This algorithm consists of extensive pre-operative psychiatric assessment, diagnostic hybrid prosthetic fitting including fMRI analyses, multidisciplinary board advice as well as targeted muscle reinnervation and amputation procedures with final prosthetic fitting and rehabilitation. By involving multiple disciplines, this algorithm should provide optimized and individualized patient treatment on the one hand and a reliable base for decision making for therapists on the other.
Item Description:Gesehen am 17.08.2022
Physical Description:Online Resource
ISSN:2043-7749
DOI:10.3390/jpm12071169

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