{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T11:17:22Z","timestamp":1767957442013,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Finger amputation is frequently followed by complications, with reported revision rates of up to 20%. One of the most disabling sequelae is the formation of painful neuromas, occurring in approximately 3\u20139% of cases. Several biological and mechanical risk factors have been proposed, but the potential influence of psychological traits remains poorly understood. This study aimed to investigate whether a correlation exists between patients\u2019 personality traits and the development of neuropathic pain or related symptoms. Methods: A retrospective study was conducted at a Level II Hand Trauma Center, including patients who underwent digital amputation between 2021 and 2023. Neuropathic pain and cold intolerance were assessed using the S-DN4 and CISS questionnaires, respectively. Personality traits were evaluated using the BFI-10 scale. Demographic data and other clinical risk factors, including work-related injuries, psychiatric history, infection, treatment delay, and surgical technique, were also analyzed. Results: A total of 54 patients were included. Neuropathic pain, defined by an S-DN4 score \u2265 4, was identified in 10 patients (18.5%). A significant correlation was found between the occurrence of neuropathic pain, cold intolerance, and the \u201cneuroticism\u201d personality trait. Patients with work-related injuries or psychiatric disorders also showed a higher risk of neuropathic pain and cold intolerance. Conversely, infection and delayed treatment were associated with an increased risk of revision procedures, whereas the type of surgical technique used for nerve stump management was not significantly correlated with pain outcomes. Conclusions: The study demonstrated a meaningful association between the neurotic personality trait and both neuropathic pain and cold intolerance after finger amputation. Additionally, work-related injuries and psychiatric comorbidities were identified as potential risk factors. Patients exhibiting these characteristics may benefit from early psychological assessment and multidisciplinary management to prevent further complications and improve postoperative outcomes.<\/jats:p>","DOI":"10.3390\/jcm15020539","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T09:25:02Z","timestamp":1767950702000},"page":"539","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Neuropathic Pain in Digital Amputations"],"prefix":"10.3390","volume":"15","author":[{"given":"Alessandro","family":"Crosio","sequence":"first","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierpaolo","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Pellegrini Hospital, ASL NAPOLI 1, Via Portamedina alla Pignasecca, 80134 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8796-9936","authenticated-orcid":false,"given":"Maria Carolina","family":"Fra","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Ospedale Borgo Trento of Verona, AOUI Veron, Piazzale Aristide Stefani, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Monticelli","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Cicirello","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Teodori","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Colzani","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Fenoglio","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-3297","authenticated-orcid":false,"given":"Davide","family":"Ciclamini","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology, AOU Maggiore Della Carit\u00e0 Hospital, Corso Mazzini 18, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Titolo","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Battiston","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery and Reconstructive Microsurgery, Trauma Hospital, Citt\u00e0 Della Salute e Della Scienza di Torino, Via Zuretti 29, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3242","DOI":"10.1016\/j.bjps.2022.06.033","article-title":"Prevalence of Post-Traumatic Neuropathic Pain after Digital Nerve Repair and Finger Amputation","volume":"75","author":"Duraku","year":"2022","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1177\/15589447211065074","article-title":"Digital Nerve Management and Neuroma Prevention in Hand Amputations","volume":"18","author":"Maslow","year":"2023","journal-title":"HAND"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1054\/jhsb.2000.0372","article-title":"Centro-Central Union for the Prevention of Neuroma Formation after Finger Amputation","volume":"25","author":"Belcher","year":"2000","journal-title":"J. Hand Surg."},{"key":"ref_4","unstructured":"Zabaglo, M., and Dreyer, M.A. (2025). Neuroma, Statpearls Publishing."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.1016\/j.injury.2020.03.018","article-title":"Prevention of Symptomatic Neuroma in Traumatic Digital Amputation: A RAND\/UCLA Appropriateness Method Consensus Study","volume":"51","author":"Crosio","year":"2020","journal-title":"Injury"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/1558944718790577","article-title":"Cost-Effectiveness of Initial Revision Digit Amputation Performed in the Emergency Department Versus the Operating Room","volume":"15","author":"Gil","year":"2020","journal-title":"HAND"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ncl.2010.10.007","article-title":"Neuropathic Pain: Mind-Body Considerations","volume":"29","author":"Hainline","year":"2011","journal-title":"Neurol. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.neubiorev.2014.08.002","article-title":"Emotional consequences of neuropathic pain: Insight from preclinical studies","volume":"47","author":"Yalcin","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1097\/j.pain.0000000000003103","article-title":"Multimodal covarying brain patterns mediate genetic and psychological contributions to individual differences in pain sensitivity","volume":"165","author":"Zhang","year":"2024","journal-title":"Pain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/papr.12006","article-title":"Validation of the Dutch version of the DN4 diagnostic questionnaire for neuropathic pain","volume":"13","author":"Vos","year":"2013","journal-title":"Pain Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/1758998314531111","article-title":"Cold Intolerance Assessment: A Reappraisal","volume":"19","author":"Davey","year":"2014","journal-title":"Hand Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/jns.12376","article-title":"Cold Intolerance and Neuropathic Pain after Peripheral Nerve Injury in Upper Extremity","volume":"25","author":"Magistroni","year":"2020","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.paid.2014.11.053","article-title":"An Italian Version of the 10-Item Big Five Inventory: An Application to Hedonic and Utilitarian Shopping Values","volume":"76","author":"Guido","year":"2015","journal-title":"Personal. Individ. Differ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jrp.2006.02.001","article-title":"Measuring Personality in One Minute or Less: A 10-Item Short Version of the Big Five Inventory in English and German","volume":"41","author":"Rammstedt","year":"2007","journal-title":"J. Res. Personal."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.bjps.2013.06.019","article-title":"The incidence of symptomatic neuroma in amputation and neurorrhaphy patients","volume":"66","author":"Hovius","year":"2013","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"86.e1\u201386.e8","DOI":"10.1016\/j.jhsa.2017.08.021","article-title":"Symptomatic Neuroma Following Initial Amputation for Traumatic Digital Amputation","volume":"43","author":"Vlot","year":"2018","journal-title":"J. Hand Surg. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1016\/j.injury.2020.11.006","article-title":"Long-Term Clinical Results of 33 Thumb Replantations","volume":"51","author":"Giardi","year":"2020","journal-title":"Injury"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1002\/msc.1797","article-title":"Beyond Yellow Flags: The Big-Five Personality Traits and Psychologically Informed Musculoskeletal Rehabilitation","volume":"21","author":"Williams","year":"2023","journal-title":"Musculoskelet. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1037\/pspp0000385","article-title":"Stability and Change in the Big Five Personality Traits: Findings from a Longitudinal Study of Mexican-Origin Adults","volume":"122","author":"Atherton","year":"2022","journal-title":"J. Personal. Soc. Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105673","DOI":"10.1016\/j.neubiorev.2024.105673","article-title":"Neuropathic Pain, Mood, and Stress-Related Disorders: A Literature Review of Comorbidity and Co-Pathogenesis","volume":"161","author":"Vieira","year":"2024","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Nguyen, T.T., Nguyen, H.V., Vu, H.M., Chiu, R.G., Nguyen, Q.N., Nguyen, T.T.P., Nguyen, L.H., Dang, A.K., Do, K.N., and Nguyen, T.H. (2023). Factors Correlated with Neuropathic Pain among Industrial Workers in Vietnam: A Multi-Site Cross-Sectional Study. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1007483"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.pathophys.2017.04.001","article-title":"Pro and Anti-Inflammatory Cytokine Levels (TNF-\u03b1, IL-1\u03b2, IL-6 and IL-10) in Rat Model of Neuroma","volume":"24","author":"Khan","year":"2017","journal-title":"Pathophysiology"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Yang, H., Dong, Y., Wang, Z., Lai, J., Yao, C., Zhou, H., Alhaskawi, A., Ezzi, S.H.A., Kota, V.G., and Abdulla, M.H.A.H. (2023). Traumatic Neuromas of Peripheral Nerves: Diagnosis, Management and Future Perspectives. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.1039529"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Crosio, A., Rosanda, E., Latini, F., Clemente, A., Locatelli, F.M., Magnani, M., Marenghi, L., and Tos, P. (2025). The Recurrence of Painful Neuromas of the Limbs Following TMR. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041078"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e4229","DOI":"10.1097\/GOX.0000000000004229","article-title":"Failed Targeted Muscle Reinnervation: Findings at Revision Surgery and Concepts for Success","volume":"10","author":"Felder","year":"2022","journal-title":"Plast. Reconstr. Surg. Glob. Open"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/539\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T09:35:32Z","timestamp":1767951332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,9]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020539"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020539","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,9]]}}}