Secondary reconstructive surgery following major upper extremity replantation. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Little literature currently exists on reconstructive strategies following successful upper extremity replantation. The authors hypothesized that the type of secondary surgery would vary predictably depending on mechanism and amputation level. METHODS: The authors performed a retrospective review of upper extremity replantations performed at their institution between 2003 and 2012. The mean follow-up period was 3 years. Patient, injury, and surgical demographics, as well as replantation survival rates and secondary surgical procedures, were recorded. RESULTS: Forty-five upper extremity replantations met inclusion criteria and the survival rate was 89 percent (n = 40). In 40 cases of successful replantation, the average number of secondary surgical procedures was three per patient (range, zero to seven). The most common reconstructive procedures were soft-tissue coverage (n = 24), tenolysis (n = 24), free functioning muscle transfer (n = 18), and tendon transfer (n = 14). For upper arm replantations, soft-tissue coverage was the most common secondary surgery; free functioning muscle transfer was the most common for amputations between the elbow and mid-forearm; tenolysis was the most common secondary procedure performed for amputations of the distal forearm to wrist. CONCLUSIONS: Proximal-level amputations commonly required soft-tissue coverage. Amputations through the proximal forearm and elbow often underwent free functioning muscle transfer, and tenolysis was the most common secondary surgery following distal forearm and wrist amputations. Secondary surgery could be predicted based on the anatomic levels of injury.

publication date

  • October 1, 2014

Research

keywords

  • Amputation, Traumatic
  • Arm Injuries
  • Plastic Surgery Procedures
  • Replantation

Identity

Scopus Document Identifier

  • 84922392393

Digital Object Identifier (DOI)

  • 10.1097/PRS.0000000000000538

PubMed ID

  • 24945950

Additional Document Info

volume

  • 134

issue

  • 4