Neuroma prevalence and neuroma-associated factors in patients with traumatic lower extremity amputation

Abstract

Aims:There is limited understanding of factors related to the development of symptomatic neuromas. The aims of this study were to determine the prevalence of neuroma in amputees with residual limb pain (RLP) and to examine factors associated with neuromas.Methods:A retrospective and cross-sectional study was conducted at the amputee rehabilitation unit of a tertiary hospital in Turkey. Demographic, clinical, ultrasonographic and radiographic records between September 2016 and April 2020 were evaluated. Bone anatomy in the affected limb was evaluated by radiographic examination. Both neuroma site and size were evaluated with ultrasonography.Results:A total of 85 patients (107 amputations) were included in the study. Neuroma was detected in 47.1% of the patients with RLP. Sixty percent of the patients with neuroma had a duration of longer than 5 years since amputation. The most common amputation level was transtibial (below-the-knee, 61.9%). Neuroma was more frequently identified in patients with landmine injury (57.5%) than without (37.8%). A correlation was found between the time after amputation and the neuroma size (r=0.47, p=0.001). There was no correlation between visual analog scale scores and neuroma size (r=-0.09, p=0.570). There was also no relationship between bone spurs and neuromas.Conclusions:Half of lower limb amputees with RLP were found to have neuromas. Clinicians should be aware of the high prevalence of neuroma among the causes of RLP to manage the rehabilitation procedure of these patients appropriately.

Keywords

• amputation
• neuroma
• pain
• ultrasound
• radiography