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Background and objective. Neuropathic pain is one of the most common complications in lower extremity amputation surgery. In this context, Targeted Muscle Reinnervation (TMR) emerges as a technique with promising results in the treatment of neuropathic pain after amputation and phantom limb. In this article we describe the surgical technique and our clinical experience. Methods. Between January 2021 and December 2022, we registered the patients operated on for delayed TMR of the lower extremity in the Plastic Surgery Service of the Miguel Servet University Hospital (Zaragoza, Spain) evaluating their ability to wear prostheses 6 months after the intervention. Likewise, we expose the surgical technique used. Results. A total of 9 patients were operated, being 7 infracondylar and 2 supracondylar amputations. Six months after surgery, 7 patients could walk with the prosthesis, while the other 2 ones still experienced pain that prevented fitting the prosthesis. Both patients had been amputated for vascular causes. Conclusions. In our clinical series, we obtained promising results which allow ambulation in a large proportion of patients although we consider that patient selection is a crucial point in the application of this technique. [ABSTRACT FROM AUTHOR]

Background: phantom limb pain (PLP) is any painful sensation referred to the absent limb, which has been partially or totally removed. The aetiology and physiopathology of PLP are not clear. There are some theories that propose answers to this phenomenon's questions. Both the Peripheral Nervous System and Central Nervous System seems to be implicated. The treatment for the PLP has approaches from different health disciplines, such as medicine, pharmacology, psychology, and physiotherapy. Objective: the main objective of this study is to know the effectiveness of the treatments of physiotherapy in the management of phantom limb pain in amputees. Material and method: a systematic review completed in the data bases of PubMed, Cochrane, PEDro and SciELO was carried out. Articles selected were clinical trials, case reports and observational studies published from 2009 until now, that explain therapies or treatments of physiotherapy in amputees with phantom limb pain. Results: 15 studies were included in this systematic review. Despite of the heterogeneity in the sample size, variables and treatments, the results were positive for the decrease of phantom limb pain after intervention. Conclusion: physical therapy treatments may be effectives in reducing the phantom limb pain in most of amputee patients; nevertheless, more studies with RCS design are necessary to determine its effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: In some patients is not possible control local cancer. The process of amputation in cancer patients has a strong psychological and emotional impact. The study of psychological interventions in amputee's patient's hasn't been studied enough. Objective: A Review of the psychological in the amputee patient and identify the effects of the psychological intervention. Method: Make a review of literature in the search engines Pubmed and Science Direct in the period 2000-2013. Results: Patients with psychological presents a 40% less depression; the group that completed the treatment show a reduction in the probability to be depressive in the post treatment. Conclusions: Patients who receive a psychological intervention in compare with whom not, show a significant differences in coping in front to amputation, being the self-regulation technic of election. It's necessary to apply strategies than promoted to develop of technics as self-regulation with the purpose for symptom reduction of anxiety, depression and therapeutical adherence. [ABSTRACT FROM AUTHOR]

Phantom limb syndrome patients experience uncomfortable sensations corresponding to a previously amputated body part. This paper extensively evaluates three cases of patients with phantom limb pain that underwent a treatment based on electromyographic biofeedback. The study involved five men and one woman with upper limb amputation. Treatment consisted of ten sessions of EMG biofeedback, with a frequency of twice a week. In addition, beliefs about the phantom limb and its effects on everyday life were collected through semi-structured interviews about the attenuation of pain. Three participants who completed the study reported on the monitoring carried out two months after a reduction of 46.8% in the intensity of pain, and had been attenuated phantom sensation. In conclusion, we can say that the data obtained are promising, but further studies with a much larger sample and where a greater control of the variables is given are required. [ABSTRACT FROM AUTHOR]

Introduction: In the body of the world experience, the joy, the meeting, security, inherently the anatomophysiological pain body reactions; the condition for the physical and mental pain, bodily sensations of anxiety, fear and anxiety is experienced. Materials and Methods: A qualitative descriptive, exploratory approach; as semi-structured interview technique was employed, selected informants were people who were treated at the General Hospital of Durango, Mexico; involving 12 people to be amputated debuted with phantom limb pain theoretical support was supported by the corporeality of Le Breton. Results and Discussion: In the amputee, the relationship with the world is altered, and that amputation not only change the way you look to yourself, but also how to interact with their environment, their family, friends, colleagues and society in general. Conclusions: The nurse must strengthen the nurse / person relationship living a real encounter showing attitude of empathy, always there helping, supporting and listening, understanding and educating, as the person feeling care contribute to be treated as a complete and will in their daily experience of living with phantom limb pain is transformed into an acceptable condition allowing you to better cope with their situation. [ABSTRACT FROM AUTHOR]

Introduction: Phantom limb pain may be present in up to 80% of patients subjected to amputation because of trauma or peripheral vascular disease. Several factors have been associated with its occurrence, including pre-amputation pain, the etiology, and the amputation level. Objective: To review the current status of the pathophysiological mechanisms, treatment options and their efficacy for the management of phantom limb pain. Method: Non-systematic review of the literature in PubMed and Cochrane, of articles describing the pathophysiology and treatment of phantom limb pain. Results and conclusions: The proposed pathophysiological mechanisms are still in research and include peripheral, central and psychological factors. Treatment options are still limited, and less than 10% of patients report long-term improvement. [ABSTRACT FROM AUTHOR]

The physician has to know the patient in the disease and not only the disease in the patient, from the dual perspective of the body as object and the body as subject. This also affects the patient who has to cope with the reality of having a body that bursts into the subject's consciousness as a vital threat, as source of discomfort and inability and being a body (Marcel). The human body in its dual aspect has been and is a great unknown, if not a great outrage in spite of the fact that we are our body and our body is each of us. We sometimes do not feel as we are and thus a confrontation arises, sometimes more normal, others more morbid. This forces the physician to face complex ethics considerations and the scientist to accept a personal identity disorder. Dualism considers that there are two substances in us, one that distinguishes us from other beings and from the rest of the individuals of the human species, the soul, the psychic life, mind or consciousness, and another more insubstancial one, the body. The aim of the first substance is to dominate the body, to survive it after death when it is, already a corpse that will become putrefied, is buried, incinerated or thrown to the depth of the sea. This dualism aims to explain the origin of the evil and the attitude to defeat it and it does so efficiently. This anthropology has very ancient roots (the Upvanishads, in the orphic texts, in Plato), it is the core of Gnostic thought and the foundation of the modern science since Descartes. Some monist perspectives are a masked dualism or a mereologic fallacy, according to which, the brain is conscious, when that what is conscious is the subject, although the subject, with the brain could not be conscious. Therefore, a new perspective is proposed, chiasmatic or janicular monism, that considers the adaptive value of focusing on the reality from two perspectives, as physical universe and the world of interpersonal relationships. In the agnosias and in the phantom limb there is a confrontation between the body object and the body subject that has made it possible to investigate how the perception of the own body is and how the brain generates the schema and the body image. The study of the body experience, from the phenomenology and the anthropological psychiatry perspective, has made it possible to go greater in-depth into the knowledge of the alterations of the experience of the own body in different mental diseases, especially in those in which a confrontation between the body and the personal identity arises makes it necessary to consider the process of individual identification and a category of personal identity disorders that would include body dysmorphic disorder, erythrophobia, anorexia nervosa, body integrity identity as well as the gender-type disorders (transsexualism, non-fetishistic transvestism, gender identity disorder during childhood). [ABSTRACT FROM AUTHOR]