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Amputation

Phantom Limb

A baffling medical phenomenon associated with amputation is the amputee's perception of a phantom limb. In these cases, which are quite common among amputees, the amputees will perceive their amputated limb as though it still exists as part of their body. This phantom limb may be so real to an amputee that he or she may actually try to stand on a phantom foot or perform some task such as lifting a cup with a phantom hand. Although amputees may feel a number of sensations in a phantom limb, including numbness, coldness, and heat, the most troubling sensation is pain. Approximately 70% of all amputees complain of feeling pain in their phantom limbs. Such pain ranges from mild and sporadic to severe and constant.

Although it probably is related to the central nervous system, the exact cause of the phantom limb phenomenon is unknown. Theories on the origin of the phantom limb phenomenon include impulses from remaining nerve endings and spontaneous firing of spinal cord neurons (nerve cells). More recent studies indicate that the phenomenon may have its origin in the brain's neuronal circuitry.

Treatments for phantom limb pain include excision (cutting out) of neuromas (nodules that form at the end of cut nerves), reamputation at a higher point on the limb, or operation on the spinal cord. Although success has been achieved with these approaches in some cases, the patient usually perceives pain in the phantom limb again after a certain interval of time.


Resources

Books

Atlas of Limb Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles. 2nd ed. New York: Mosby Year Book, 1992.

Barnes, Robert W., and Birck Cox. Amputations: An Illustrated Manual. Philadelphia: Hanley & Belfus, 2000.

Bella J., Edd, and Fapta May Pt. Amputations and Prosthetics: A Case Study Approach. 2nd ed. New York: F. A. Davis, 2002.

Murdoch, George, and Wilson A. Bennett, Jr. A Primer on Amputations and Artificial Limbs. Springfield, IL: Charles C. Thomas, 1998.


Periodicals

Johnston, J., and C. Elliott. "Healthy Limb Amputation: Ethical and Legal Aspects." Clinical Medicine 2, no. 5 (September/October, 2002):435-435.

McPhee, A.T. "Scientist Solves Mystery: Why a Missing Arm Itches." Current Science 78 (1993): 8-9.

Melzack, Ronald. "Phantom Limbs." Scientific American (April 1994): 120-126.

Mulvey, Martha A. "Traumatic Amputation." RN 54 (1991): 26-30.

Sherman, R. "To Reconstruct or Not to Reconstruct?" New England Journal of Medicine 12, no. 347-24 (2001):1906-7

van der Schans, C.P., et al. "Phantom Pain and Health-related Quality of Life in Lower Limb Amputees." Journal Pain Symptom Management 24, no.4 (October, 2002):429-36.


David Petechuk

KEY TERMS

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Congenital

—A condition or disability present at birth.

Ligature

—The use of thread or wire to tie off blood vessels.

Tourniquet

—A device used to stop blood flow.

Trauma

—A severe injury.

Additional topics

Science EncyclopediaScience & Philosophy: Ambiguity - Ambiguity to Anticolonialism in Middle East - Ottoman Empire And The Mandate SystemAmputation - History, Reasons For Amputation, Levels And Goals Of Amputation, Prosthetics And Limb Reattachment, Phantom Limb