[Nerve healing in an amputation stump in aseptic conditions and with suppuration].
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In five patients, with intractable pain from neuromas that developed after amputations at the wrist or forearm, the neuromas were resected and the median nerve anastamosed to the ulnar nerve under the pronator teres muscle. In one patient, the anterior interosseous nerve was also anastamosed to the superficial radial nerve under the muscles of the forearm. Patients reported an 80% to 90% reduction in pain. This procedure is limited to patients in which all other treatments have failed.
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When the traumatic amputation level or the degree of damage to the arm or forearm does not justify reimplantation of the severed part there may be sufficient undamaged skin to be used as a free flap to resurface the arm or the stump. Stump length or the elbow joint may thus be preserved and more durable skin cover for the fitting of a prosthesis may be obtained. A "spare-parts" forearm free flap may be raised on the radial or ulnar vessels or both. Three cases are reported.
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