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Related Experiment Video

Updated: Aug 30, 2025

Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
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Early One Stage Functional Reconstruction of a Mangled Upper Extremity.

Debarati Chattopadhyay1, Akshay Kapoor1, Praveen A Jayaprakash1

  • 1Department of Burns and Plastic Surgery, All India Institute of Medial Sciences, Veerbhadra Road, Rishikesh, Uttarakhand 249202 India.

Indian Journal of Orthopaedics
|September 2, 2022
PubMed
Summary

Single-stage reconstruction using a Latissimus Dorsi flap can restore function in mangled upper extremities. This approach offers a promising alternative to multiple surgeries for severe crush injuries, improving patient outcomes.

Keywords:
ExtremityFunctionalLatissimus dorsiMangledPedicled flapReconstruction

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Trauma Surgery

Background:

  • Severe upper extremity crush injuries (Mangled Extremity Severity Score ≥ 10) often have poor salvage prognosis.
  • Traditional multi-stage surgeries lead to complex rehabilitation and poor patient compliance.
  • A single-stage functional reconstruction aims to overcome these challenges.

Purpose of the Study:

  • To present a case of single-stage functional reconstruction for a mangled upper extremity.
  • To evaluate the efficacy of a Latissimus Dorsi flap in restoring function.

Main Methods:

  • A young female with a crush injury underwent limb salvage surgery.
  • A Latissimus Dorsi (LD) flap was used for functional reconstruction 48 hours post-surgery.
  • The flap covered the shoulder and elbow joints and provided motor function for elbow flexion.

Main Results:

  • The patient regained active motion in the elbow and shoulder joints within 6 months.
  • At 1 year post-surgery, the patient could perform activities of daily living independently.

Conclusions:

  • Mangled upper extremities require tailored surgical approaches.
  • Single-stage functional reconstruction with an LD flap is a viable option for severe injuries.
  • Maximizing autologous functional reconstruction is crucial for optimal patient outcomes.