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[Cross-hand replantation in bilateral upper limb amputation: An anatomical emergency]
A Andre1, M Rongieres1, J-M Laffosse2
1Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France; Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
Abstract:
Bilateral amputations of upper limbs are excessively rare clinical situations. We report an exceptional clinical case of bilateral amputation of upper limbs at different levels: destruction of the right hand and left transhumeral amputation in a patient after an attempted suicide on train lines. This special situation led us to perform a cross-hand replantation of the left hand to the right forearm. Only 4 other similar cases have been published in the literature. Once the surgical indication had been formulated collectively, and taking into account all the ethical issues surrounding such a decision, we had to solve the issue of inverting anatomical structures in emergency. We have provided a detailed description of our surgical technique. The aim was to save at least one organ used for grasping. The result obtained is presented and reviewed.