The phantom limb experience and sensory phenomena in a relocated limb in a case of fillet flap used to reconstruct a massive wound proximal to an above-knee amputation.

A 41-year-old male sustained a massive crushing injury to his left posterior thigh and buttock and transection of the sciatic nerve; he underwent an above-knee amputation with fillet flap. He was interviewed 24 months post-operatively to determine his phantom limb experience. At 37 and 42 months, testing for touch-pressure sensitivity of the residual limb and buttock was done with a 1-gram monofilament. Results: (1) He described a typical phantom limb with some unusual features. (2) Stimulation of points on transposed and original skin were located accurately or roughly according to normal anatomy, were mislocated, or felt simultaneously at the point stimulated and another place, i.e., bilocations. It It is hypothesized that such mislocations and bilocations represented clinical correlates of cortical somatosensory reorganization. It is not clear why a typical phantom limb could occur when there was only partial deafferentation of the limb. Further studies are recommended.