[A combination of amputation of the upper arm and a plexus lesion. Case report]

A 17-year-old male sustained an amputation of his left arm and a simultaneous complete brachial plexus lesion on the same side. The median nerve was torn nearly completely out of the amputate and the ulnar nerve was avulsed of the stump. The severed extremity was replanted without primary nerve reconstruction. In a further operation three and one-half months later, a neurolysis of the left brachial plexus was performed and the proximal stump of the median nerve was connected to the distal stump of the ulnar nerve using nerve grafts. Two years post trauma the patient has regained sensibility down to the fingertips. He can actively abduct the shoulder, extend his elbow joint, and flex his wrist joint and fingers. The question about replantation of a severed extremity with a coexistent complete brachial plexus lesion is discussed.