Successful revascularization of near total amputation of the upper limb at the sultan qaboos hospital, salalah (original) (raw)
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Severe complex injuries to the upper extremity: Revascularization and replantation
The Journal of Hand Surgery, 1991
Twenty-nine patients with an incomplete (26) or a complete (3) amputation of the upper extremity proximal to the wrist with revascularization or replantation were reviewed. Limb survival rates were very high (93%) despite the severity of the injuries. All patients regained some useful hand function, with 76% attaining a group I or group II (Chen criteria) functional result. Bone shortening osteotomies are a helpful way to reduce the soft tissue defect size. In contrast to earlier studies, clear correlations between the level of injury, degree of nerve lesion, bone pathology, and the number of major nerves involved, and the functional outcome achieved were not found. There was a weak correlation between the type of wound and the functional recovery ultimately obtained. (J HAND SURC 1991;16A:574-84.)
Revascularization of post-traumatic leg amputation: a case report
Ghana Medical Journal
There are few reports on lower extremity revascularization because of its high risks of general and local complications as well as poor functional prognosis. However, revascularization of the traumatically amputated lower extremity is a technically feasible surgical undertaking if there can be effective collaboration between the orthopaedic surgeon and the vascular surgeon. Successful outcome is usually judged by functional achievements of the patient toward returning to the preinjury level. Appropriate patient selection significantly increases the potential for obtaining a satisfactory outcome. We report the successful revascularization of a near amputation of the right leg of a young man who was knocked down accidentally by a speeding taxi leading to mangled and near amputation of his right leg. He underwent successful revascularization and currently doing well, one year after the surgery. Successful revascularization is possible if indicated in less resource countries especially if there is an experienced team of vascular and orthopaedic surgeons.
Near Hand Amputation: A Report of Four Cases
PriMera Scientific Surgical Research and Practice , 2024
Background: The hand is an important part of the body that helps man express his thought and skills to the physical world. It is very essential to both function and cosmesis. Loss of this important body part can be devastating to the victim. We defined near total hand amputation as injury between the wrist and musculotendinous junction of extrinsic muscles of the hand transecting extensor and flexor compartment structures either passing through the wrist joint or transecting the two bones of the forearm leaving the hand attached to strip(s) of soft tissue. There are few reported cases of this type of injuries and most often completion amputation is done with loss of the hand. This study reports the outcome of near total hand amputation repair without revascularization in four patients seen and managed in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in 2020. This shows that with basic surgical equipment, hand salvage surgeries can be done with very good outcome. Methods: Consecutive Patients with near total hand amputation seen and managed in ATBUTH in 2020 were recruited for this case series report. Results: Four patients with such injury were seen and managed within four months in 2020. Three had their hands repaired with very good outcome while one had a completion amputation. Three out of the four had injury to their right hand, all four were right-handed males in their third decade of life and injuries commenced from ulnar borders. Majority had transection of virtually all structures except branches of major vessels. Conclusion: The study shows that a number of near hand amputation can be salvaged with basic equipment with significant functional and cosmetic outcome.
Indications, complications, and revisions of amputations in Turkey
2020
Aim: The objective of this study is to determine the incidence of indications for amputations, major amputation related complications and revision numbers in Level I trauma center; which consists burn care unit, hyperbaric oxygen unit and hand surgery department in Turkey. Materials and Methods: Amputation procedures were retrospectively reviewed and evaluated according to the amputation levels, etiology, and demographic data. Major complications that require surgical intervention, type of surgical intervention for these complications and interval between index surgery and first complication related surgery were recorded. Re-amputations were evaluated according to interval between index and revision surgery, revision indication, and revised level. Results: A total of 558 amputations were performed for 476 patients (367 male, 109 female) in fiveyear period. The most common indication of amputation was diabetic complications, 250 amputations for 215 diabetic patients (44.8%) were perf...
Traumatic and trauma-related amputations: Part II: Upper extremity and future directions
The Journal of bone and joint surgery. American volume, 2010
Trauma is the most common reason for amputation of the upper extremity. The morphologic and functional distinctions between the upper and lower extremities render the surgical techniques and decision-making different in many key respects. Acceptance of the prosthesis and the outcomes are improved by performing a transradial rather than a more proximal amputation. Substantial efforts, including free tissue transfers when necessary, should be made to salvage the elbow. Careful management of the peripheral nerves is critical to minimize painful neuroma formation while preserving options for possible future utilization in targeted muscle reinnervation and use of a myoelectric prosthesis. Rapid developments with targeted muscle reinnervation, myoelectric prostheses, and composite tissue allotransplantation may dramatically alter surgical treatment algorithms in the near future for patients with severe upper-extremity trauma.
Lower limb amputation in trauma sequelae: choice of level and techniques
Lo Scalpello - Otodi Educational
The main purpose of amputation is to bring a specific patient, regardless of the initial scenario, to a new normality, characterized by the absence of pain and functional potential of the stump in terms of wearability and power. It is therefore implicit that the strategy is played on the choice of the level, using both analysis of the scenario of the patient and the perspective of the prosthetic project. Hence the delicacy of the choice of the moment and the level of amputation, considering multiple possibilities arising from evolution of surgical techniques, interdigitation of skills between traumatologist and plastic surgeon, translation of some techniques initially used for amputations of the upper limb to amputations of the lower limb, to substantial innovations in limb prostheses.
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi
This study aimed to examine the characteristics of traumatic minor digital amputations in patients presenting to the emergency department, who were candidates for replantation and revascularization and to discuss the clinical outcomes of these patients. Upper extremity total/subtotal amputation cases presenting to Private Erzurum Buhara Hospital emergency department between January 1, 2018, and January 1, 2021, were retrospectively evaluated. The demographic characteristics, occupational status, etiology and type of injury, localization and level of injury, time to arrive at hospital and undergo surgery, length of hospital stay, and survival outcomes were recorded for a total of 134 patients. Of the patients, 88.1% were male, and the mean age was 36.45±20.87 years. Injuries were most commonly seen in those working in agriculture, at a rate of 61.4%. The most common injury type was avulsion (45.5%). The most common specific cause (16.4%) was related to throttle belt use. The mean tim...
Revascularization of a subtotal amputated extremity and it synchronous functional reconstruction
Turk J Plast Surg 2012;20(2), 2012
A thirty year old male patient presented to our hand surgery team 2 hours after a motor vehicle accident. His physical examination revealed lack of circulation in his right forearm with totally severed median and ulnar nerves and loss of forearm flexion. Additionally, a 14 x 7 cm skin area was lost. After brachial artery anastomosis with vein graft and median and ulnar nerve coaptation, a functional latissimus dorsi musculocutaneous flap was transferred to maintain elbow flexion and defect coverage. However, an excursion problem occurred in the post operative third month. In order to fix this, insertio of the muscle was transferred to a more proximal position. Post operative one year result was satisfactory with the complete flexion of the elbow. This problem appears to occur due to insufficient muscle relaxation during first surgery. In this report the importance of the monitoring anaesthesia and muscle relaxation during this type of functional muscle transfer was stressed to ensure optimum results.