ABSTRACT
Traumatic near total amputation of the hand with major vascular injury may lead to loss of the hand with dire consequences to the patient. A prompt attempt at salvaging the hand is key to prevent the untoward consequences. In addition, the awareness of the possibility of salvage in our environment should be spread among health care personnel as well as the need for multispecialty approach to the management. We report 2 patients with near total unilateral amputation of their hands proximal to the wrist who underwent salvage procedures.
Subject(s)
Amputation, Traumatic , Limb Salvage , Amputation, Surgical , Amputation, Traumatic/surgery , Humans , Limb Salvage/methods , Retrospective Studies , Treatment Outcome , Vascular Surgical ProceduresABSTRACT
We report a case of a hand replantation. A 43-year-old male presented with an amputated right hand. After clinical and radiological examination of the amputated hand and the forearm stump, the patient was consented for hand replantation procedure. Both bones of the forearm were fixed using K-wires. Careful dissection, trimming and repair of the tendons, vessels (two arteries and one vein) and nerves was achieved. The patient tolerated the procedure well and 2 months later showed a progressive improvement in motor and sensory functions. We suggest that a single-vein repair is sufficient for a successful hand replantation.
ABSTRACT
It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Subject(s)
Humans , Amputation, Surgical , Ankle , Burns , Disarticulation , Extremities , Free Tissue Flaps , Hand , Skin , Tendons , Tissue Donors , Wounds and Injuries , WristABSTRACT
Replantation of a severed limb is an elective procedure and, as such, the decision to carry it out must be assessed anew in each case. The arm is progressively more valuable from shoulder to fingers, the leg, on the contrary, is progressively of less significance. Especially, the replantation of severed hand at the level of carpal bones or wrist joint is technically more difficult than at the level of forearm or arm. We have a successful case of replanted hand at the level of intercarpal joint without bony shortening.
