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Updated: Nov 11, 2025

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Published on: October 29, 2021

Mangled extremity- Modern concepts in treatment.

M Bumbaširević¹, S Matić², T Palibrk²

¹School of Medicine, University of Belgrade; Clinic for orthopedic surgery and traumatology, Clinical Centre of Serbia; Serbian Academy of Sciences and Arts, Belgrade.

|March 26, 2021

Summary

Mangled extremity injuries pose significant challenges, with reconstruction often yielding better outcomes than amputation when feasible. Early intervention and comprehensive treatment protocols are crucial for optimal limb function and patient recovery.

Keywords:

Limb reconstruction Mangled extremity Microsurgery Open fractures Salvage versus amputation

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Area of Science:

Orthopedic Surgery
Trauma Management
Reconstructive Surgery

Background:

Mangled extremity injuries are severe and complex, presenting difficult treatment decisions.
Reconstruction versus amputation is a common dilemma for orthopedic surgeons.
Existing scoring systems aid decision-making but surgeon experience remains paramount.

Purpose of the Study:

To outline treatment strategies for severely mangled extremities.
To emphasize the importance of a systematic approach to limb salvage.
To highlight key components of successful extremity reconstruction.

Main Methods:

Review of treatment options for mangled extremities.
Description of a protocol for assessing and treating all injured tissues.
Focus on bone stabilization, revascularization, soft-tissue coverage, and nerve reconstruction.

Main Results:

Early reconstruction generally leads to superior outcomes compared to delayed procedures.
Successful reconstruction requires meticulous management of bone, vascular, soft tissue, and nerve components.
Restoring lower extremity function focuses on balance and ambulation; upper extremity function is more complex.

Conclusions:

A defined protocol for mangled extremity treatment, prioritizing early reconstruction, can improve outcomes.
Comprehensive management addressing all injured tissues is essential for limb salvage.
Rehabilitation is a lengthy process with uncertain return to pre-injury function.