Aydemir Koray, Demir Yasin, Güzelküçük Ümüt, Tezel Kutay, Yilmaz Bilge
From the Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Gülhane Military Medical Academy, Bilkent, Ankara, Turkey.
Am J Phys Med Rehabil. 2017 Aug;96(8):572-577. doi: 10.1097/PHM.0000000000000687.
The current study was designed to document clinical and ultrasound (US) findings of patients with residual limb pain (RLP) after amputation and to investigate the relationship between these findings.
A chart review was performed to identify demographic and clinical data including the age (current and at the time of injury), time since amputation, gender, reason for amputation, affected limb number, side and level of limb loss, and ultrasonographic findings of young and traumatic amputees with RLP.
The study included a total of 147 patients. Inflammation and neuroma were the leading pathologies in 20-29 years and 30-39 years age groups, respectively. Inflammation/edema were detected significantly more in patients with <1 year since amputation (P = 0.001). Neuroma was found at a significantly high rate in patients at 1-5 years (P = 0.029) and infection/abscess was more common in patients at >5 years since amputation (P = 0.051). The percentage of neuromas in below-the-knee amputees was significantly higher than in non-below-the-knee amputees (45.8% vs. 28.6%). Neuroma formation was detected in 50% of the patients with land mine-related amputation and at 27% in patients with amputation secondary to other traumatic reasons. Regression analysis showed below-the-knee-level amputation to be an associated factor for US abnormality.
The leading US findings were inflammation/edema, neuroma, and infection/abscess in traumatic amputees with RLP. The US findings might be different in patients according to the time since amputation. Patient with land mine-related amputations may have different US findings.
本研究旨在记录截肢后残肢疼痛(RLP)患者的临床和超声(US)检查结果,并探讨这些结果之间的关系。
进行图表回顾,以确定人口统计学和临床数据,包括年龄(当前年龄和受伤时年龄)、截肢后时间、性别、截肢原因、受影响肢体数量、肢体缺失的侧别和水平,以及患有RLP的年轻创伤性截肢患者的超声检查结果。
该研究共纳入147例患者。炎症和神经瘤分别是20 - 29岁和30 - 39岁年龄组的主要病理情况。截肢后<1年的患者中炎症/水肿的检出率显著更高(P = 0.001)。在截肢后1 - 5年的患者中神经瘤的发生率显著较高(P = 0.029),而在截肢后>5年的患者中感染/脓肿更为常见(P = 0.051)。膝下截肢患者中神经瘤的百分比显著高于非膝下截肢患者(45.8%对28.6%)。在与地雷相关的截肢患者中有50%检测到神经瘤形成,而在其他创伤原因导致截肢的患者中这一比例为27%。回归分析显示膝下水平截肢是超声异常的一个相关因素。
在患有RLP的创伤性截肢患者中,主要的超声检查结果是炎症/水肿、神经瘤和感染/脓肿。根据截肢后的时间不同,患者的超声检查结果可能会有所不同。与地雷相关截肢的患者可能有不同的超声检查结果。