BACKGROUND: Transmetatarsal amputation (TMA) is a commonly performed procedure that can result in residual limb and phantom pain. Neuromodulation using pulsed radiofrequency (PRF) is a growing area of research in the management of refractory postamputation pain (PAP).

CASE REPORT: A veteran in his sixties with a history of diabetes required a left TMA due to gas gangrene, subsequently complicated by severe, prolonged postoperative pain. PRF was performed first on the saphenous nerve using ultrasound guidance, then 12 weeks later on the saphenous, peroneal, and sural nerves. This resulted in analgesic effects lasting over 3 months and affording him an improved quality of life and function with his prosthetic.

CONCLUSIONS: The use of PRF for refractory PAP is not widely reported in pain literature and limited primarily to a handful of case reports; therefore, this case serves an important role in exploring the benefit this modality may provide for an otherwise refractory condition.

KEYWORDS: Pulsed radiofrequency, amputation pain, case report, neuromodulation, transmetatarsal amputation