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Similar rates of reoperation for neuroma after transtibial amputations with and without targeted muscle reinnervation.
Smith, Thomas P; Cognetti, Daniel J; Cook, Alyssa; Lynch, Thomas B; Alderete, Joseph F; Lybeck, Dustin O; Dowd, Thomas C.
Afiliación
  • Smith TP; San Antonio Military Medical Center, San Antonio, TX.
  • Cognetti DJ; San Antonio Military Medical Center, San Antonio, TX.
  • Cook A; San Antonio Military Medical Center, San Antonio, TX.
  • Lynch TB; San Antonio Military Medical Center, San Antonio, TX.
  • Alderete JF; San Antonio Military Medical Center, San Antonio, TX.
  • Lybeck DO; San Antonio Military Medical Center, San Antonio, TX.
  • Dowd TC; San Antonio Military Medical Center, San Antonio, TX.
OTA Int ; 7(1): e297, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38433988
ABSTRACT

Objective:

To compare the rates of revision surgery for symptomatic neuromas in patients undergoing primary transtibial amputations with and without targeted muscle reinnervation (TMR).

Design:

Retrospective cohort study.

Setting:

Level I trauma hospital and tertiary military medical center. Patients/

Participants:

Adult patients undergoing transtibial amputations with and without TMR. Intervention Transtibial amputation with targeted muscle reinnervation. Main Outcome Measurements Reoperation for symptomatic neuroma.

Results:

During the study period, there were 112 primary transtibial amputations performed, 29 with TMR and 83 without TMR. Over the same period, there were 51 revision transtibial amputations performed, including 23 (21%) in the patients undergoing primary transtibial amputation at the study institution. The most common indications for revision surgery were wound breakdown/dehiscence (42%, n = 25), followed by symptomatic neuroma 18% (n = 9/51) and infection/osteomyelitis (17%, n = 10) as the most common indications. However, of the patients undergoing primary amputation at the study's institution, there was no difference in reoperation rates for neuroma when comparing the TMR group (3.6%, n = 1/28) and no TMR group (4.0%, n = 3/75) (P = 0.97).

Conclusions:

Symptomatic neuroma is one of the most common reasons for revision amputation; however, this study was unable to demonstrate a difference in revision surgery rates for neuroma for patients undergoing primary transtibial amputation with or without targeted muscle reinnervation. Level of Evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: OTA Int Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: OTA Int Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos