Special Considerations for Secondary Surgery After Upper Extremity Transplantation

Area of Science:

• Reconstructive surgery
• Transplantation medicine
• Orthopedic surgery

Background:

• Upper extremity transplantation is a complex procedure.
• Secondary surgeries may be required days to years post-transplant.
• Patient and transplant factors influence the need for secondary surgery.

Purpose of the Study:

• To characterize the secondary surgeries needed by upper extremity transplant patients.
• To analyze the types of secondary procedures performed.
• To understand the impact of transplantation level on surgical needs.

Main Methods:

• Retrospective review of 6 patients undergoing hand and upper extremity transplantation.
• Analysis of medical records for transplantation and secondary surgery details.
• Quantification of hand and arm function using standardized tests and patient reports.

Main Results:

• 66.7% of patients required secondary surgery (13 procedures in total).
• Most common procedures included nerve decompressions and tendon transfers for hand function improvement in above-elbow transplants.
• Below-elbow transplant procedures included management of infection and fracture fixation.

Conclusions:

• Upper extremity transplant recipients frequently need secondary procedures.
• The type of secondary surgery often correlates with the level of transplantation.
• Secondary surgery planning is essential for pre-transplant considerations and cost-effectiveness.