{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T23:51:15Z","timestamp":1773532275371,"version":"3.50.1"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neuroma complicates lower extremity (LE) amputations causing significant morbidity. This study examines the relationship between access to plastic surgery and the likelihood of receiving a neuroma-preventing nerve procedure with LE amputation in the United States.<\/jats:p>\n                  <jats:p>Using the National Inpatient Sample, 2016 to 2021, ICD-10 codes identified encounters undergoing above- or below-knee LE amputation with or without concurrent nerve procedures (targeted muscle reinnervation and regenerative peripheral nerve interface). Plastic surgery volume was determined using ICD-10-PCS codes. Outcomes included population-adjusted LE amputation incidence, odds of concurrent nerve procedures, and their incidence relative to facility plastic surgery volume. Statistical analysis included univariate analysis and multivariate Poisson and logistic regression models.<\/jats:p>\n                  <jats:p>A total of 245,170 weighted encounters underwent LE amputation, of which only 1,525 (0.6%) included concurrent nerve procedures. Population-adjusted LE amputation incidence remained stable throughout the study period (p\u2009=\u20090.159). Higher LE amputation incidence was associated with higher comorbidity burden and Black and Native American race (p \u2264 0.036). Odds of nerve procedures increased with more recent surgery year, younger age, higher income, and Black race (p \u2264 0.044). Nerve procedure incidence at facilities in the highest quartile of plastic surgery volume was significantly higher than that of facilities in the lowest quartile (incidence rate ratio: 21.949; 95% confidence interval: 16.493\u201329.211; p\u2009&lt;\u20090.001).<\/jats:p>\n                  <jats:p>Amidst stable population LE amputation incidence, Black and Native American race increased LE amputation incidence. Higher income and Black race elevated odds of concurrent nerve procedures. Increasing facility plastic surgery volume was associated with increased concurrent nerve procedure incidence in LE amputation.<\/jats:p>","DOI":"10.1055\/a-2817-5038","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:07:42Z","timestamp":1771891662000},"source":"Crossref","is-referenced-by-count":0,"title":["Access to Reconstructive Plastic Surgery and Nerve Procedures in Lower Extremity Amputations"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3346-1930","authenticated-orcid":false,"given":"Jennifer K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1509-9229","authenticated-orcid":false,"given":"Daniel","family":"Najafali","sequence":"additional","affiliation":[{"name":"Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devi","family":"Lakhlani","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uchechukwu O.","family":"Amakiri","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahim","family":"Nazerali","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifford C.","family":"Sheckter","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, United States"},{"name":"Regional Burn Center, Santa Clara Valley Medical Center, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"ref1","volume-title":"Lower extremity amputation","author":"C S Molina","year":"2025"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"724e","DOI":"10.1097\/PRS.0000000000010664","article-title":"Current concepts in lower extremity amputation: a primer for plastic surgeons","volume":"152","author":"P J Hanwright","year":"2023","journal-title":"Plast Reconstr 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Valentine","year":"2025","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/PRS.0000000000010692","article-title":"Targeted muscle reinnervation at the time of amputation decreases recurrent symptomatic neuroma formation","volume":"153","author":"E G Goodyear","year":"2024","journal-title":"Plast Reconstr Surg"},{"issue":"11","key":"ref38","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1002\/pmrj.12972","article-title":"Targeted muscle reinnervation and regenerative peripheral nerve interfaces for pain prophylaxis and treatment: a systematic review","volume":"15","author":"J T Mauch","year":"2023","journal-title":"PM R"},{"issue":"07","key":"ref39","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1002\/micr.31030","article-title":"The application of targeted muscle reinnervation in lower extremity amputations: a systematic review","volume":"43","author":"L E 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