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Severe complex injuries to the upper extremity: revascularization and replantation
1Division of Hand Surgery, University of Bern, Inselspital, Switzerland.
The Journal of Hand Surgery
|July 1, 1991
Summary
Replantation and revascularization offer high limb survival (93%) and useful hand function for severe upper extremity amputations. Functional outcomes were good, though not strongly correlated with injury specifics.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Review of 29 patients with proximal upper extremity amputations (incomplete or complete).
- Focus on outcomes following revascularization or replantation procedures.
- Assessment of limb survival and functional hand recovery.
Observation:
- High limb survival rate of 93% despite severe injury.
- 76% of patients achieved good functional results (Chen criteria Group I or II).
- Bone shortening osteotomies aided in managing soft tissue defects.
Findings:
- No clear correlation found between injury level, nerve damage, bone pathology, or number of nerves involved and functional outcome.
- A weak correlation was observed between wound type and functional recovery.
Implications:
- Replantation/revascularization are effective for severe upper extremity amputations.
- Predictive factors for functional outcome require further investigation.
- Bone shortening osteotomies are a valuable surgical technique.