Amputation neuromata Surgery Neuroma of amputation stump
Conditions
Interventions
As part of routine clinical diagnostics, the following is performed, a neuroma is identified on ultrasound
the nerve “feeding” the neuroma is identified on ultrasound. Subsequently, a diagnostic injection of local anaesthetic is made. Temporary relief of pain is a positive diagnostic test for an amputation
Sponsors
Swansea Bay University Health Board
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adult patients (aged >18 years) 2. Capable of giving informed consent 3. Any Fitzpatrick skin type 4. Have undergone amputation (any method) subsequently complicated by the development of reduction (stump) neuroma 5. The patient is not eligible, or declines, further conventional treatment
Exclusion criteria
Exclusion criteria: 1. Photosensitising or photo-bio-modulating medications 2. Patients on psoralens 3. Patients suffering from any condition aggravated by near infra-red wavelengths 4. Patients suffering from porphyria 5. Patients on anticoagulants 6. Any condition where laser is contraindicated 7. Patients with overlying skin breaches or infection 8. Patients on anticoagulants 9. Patients with concomitant neurological conditions 10. Patients with a known history of altered sensation (e.g. Charcot’s illness) 11. Patients objecting to receiving treatment with laser 12. Patients who are pregnant 13. Patients who object to their GP being notified. 14. Patients with no targetable nerve/s identified on ultrasound 15. Patients where diagnostic injection of local anaesthetic fails to confirm a targetable nerve
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain scores recorded on a 1-10 validated scale pre- and post-treatment | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Mobility measured using the Disabilities of Arm, Shoulder and Hand (DASH) score for the upper limb and the Basic Amputee Mobility Score (BAMS) for the lower limb pre- and post-treatment 2. Neuroma size measured in mm through transcutaneous ultrasound pre- and post-treatment | — |
Countries
United Kingdom, Wales
Outcome results
None listed