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Acute management of traumatic forequarter amputations: case reports
S E Hovius1, A Hofman, H van Urk
1Department of Plastic and Reconstructive Surgery, Academic Hospital Rotterdam Dijkzigt, The Netherlands.
The Journal of Trauma
|October 1, 1991
Summary
Traumatic forequarter amputation, a severe injury involving arm and shoulder detachment, requires immediate surgical reconstruction. This study presents three survival cases managed with musculocutaneous flaps for defect closure.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Traumatic forequarter amputation is a rare, devastating injury involving the avulsion of the upper extremity, scapula, clavicle, and pectoral muscles.
- Such injuries result from high-energy traction forces, often encountered in industrial or agricultural accidents.
Observation:
- Presents three cases of traumatic forequarter amputation.
- Mechanisms of injury included entanglement in a harvesting machine axle and conveyor belts.
- All three patients survived the initial trauma.
Findings:
- Acute defect closure was achieved using reconstructive surgical techniques.
- One patient underwent closure with a local pedicled musculocutaneous flap.
- Two patients received free vascularized musculocutaneous flaps, utilizing tissue from the amputated limbs.
Implications:
- Demonstrates the feasibility of acute reconstruction in traumatic forequarter amputations.
- Highlights the successful application of both local and free vascularized flaps for defect coverage.
- Emphasizes the importance of timely surgical intervention for patient survival and limb salvage in severe traumatic injuries.