[Major upper limb trauma: patients' outcomes in 22 cases]

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Reconstructive Surgery

Background:

• Major upper limb trauma presents a critical decision between limb salvage and amputation.
• Outcomes of these two approaches require long-term evaluation for functional, psychological, and social aspects.

Purpose of the Study:

• To compare long-term functional, psychological, and social outcomes of major upper extremity trauma patients treated with amputation versus limb salvage.
• To assess patient satisfaction and quality of life in both treatment groups.

Main Methods:

• Retrospective monocenter cohort study of 22 patients with major upper limb trauma.
• Comparison of functional scores (DASH, Chen), autonomy, and psychological evaluations (NHP, EVA, Russel's score) between limb salvage and amputation groups.
• Mean follow-up of 12 years and 5 months for 16 reviewed patients (5 limb salvage, 11 amputees).

Main Results:

• All reviewed patients achieved autonomy in daily life, work, and driving.
• No significant differences were found in DASH or NHP scores between the salvage and amputation groups.
• Patients with salvaged limbs reported higher satisfaction (Russel's score) and would recommend the procedure.

Conclusions:

• Limb salvage for major upper extremity trauma provides comparable functional outcomes to amputation.
• Despite potentially disappointing macro-replantation results, patient satisfaction and body integrity preservation justify limb salvage when technically possible.
• The study highlights the importance of patient-reported outcomes in treatment decisions for severe upper limb injuries.