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Singapore Med J 2013; 54(2): 75-81; http://dx.doi.org/10.11622/smedj.2013028
Incidence of phantom limb phenomena after lower limb amputations in a Singapore tertiary hospital
Sin EI, Thong SY, Poon KH
Correspondence: Dr Sze Ying Thong, thongszeying@gmail.com
ABSTRACT
Introduction Phantom limb sensations (PLS), phantom limb pain (PLP) and stump pain (SP) are well-recognised postamputation phenomena. However, there is a dearth of related epidemiological data in Asian populations. This study was conducted to fill the information gap.
Methods Telephone interviews were conducted with patients who underwent lower limb amputations at a tertiary hospital in Singapore. Information was obtained on phantom limb characteristics, perioperative pain and functional assessment.
Results A total of 159 patients underwent amputations over a 31-month period. At the time of the interview, 47 patients had died and 66 were contactable, of whom 49 patients were interviewed. Of these, 31 (63%) patients experienced PLS. 22 patients had postoperative pain, with 9 having both PLP and SP, 3 having PLP alone and 10 having SP alone. Among the 12 patients with PLP, at least 6 (50%) experienced constant or daily pain and 7 (58%) scored their pain as moderate-to-severe. Among those with PLP and/or SP (n = 22), 5 were distressed by the pain, 11 were on analgesics and 3 received medical follow-up. 7 (32%) patients reported functional limitations secondary to PLP or SP. Altogether, 28 (57%) patients were wheelchair or bed bound.
Conclusion The incidence of PLP was 25% in our cohort. Although this is lower than that reported in other studies, it remains significant, as some patients suffered moderate-to-severe pain. The difference in incidence may be due to differences in the ethnic composition and/or indications for amputation in our group. Follow-up and care could improve the outcomes in these patients.
Keywords: chronic pain after amputation, phantom limb pain, phantom sensations, stump pain
Singapore Med J 2013; 54(2): 75–81; http://dx.doi.org/10.11622/smedj.2013028
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