Proximal Bilateral Arm Transplantation with Left Shoulder Reconstruction: Outcomes at 24 Months
Selma Lahlali1, Palmina Petruzzo2,3, Christophe Gaillard1
1From Chirurgie de la Main et du Membre Supérieur, Hôpital Edouard Herriot, HCL, Lyon, France.
Plastic and Reconstructive Surgery. Global Open
|June 11, 2024
Summary
Bilateral arm transplantation is a viable option for individuals with proximal arm amputations. This procedure restored elbow flexion, wrist extension, and finger function, significantly improving patient autonomy and body image.
Area of Science:
- Medical Science
- Surgical Innovation
- Transplantation Medicine
Background:
- Arm transplantation is a proposed therapeutic option for arm amputees.
- A bilateral arm transplantation with left shoulder reconstruction was performed in Lyon, France.
Purpose of the Study:
- To evaluate the feasibility and outcomes of bilateral arm transplantation in a patient with proximal-level amputations.
- To assess functional recovery, bone healing, and patient satisfaction post-transplantation.
Main Methods:
- A 48-year-old male recipient with bilateral proximal arm amputations underwent transplantation.
- Surgical techniques included intramedullary fibula reinforcement on the right and gleno-humeral joint reconstruction on the left.
- An immunosuppressive protocol involving antithymocyte globulins, tacrolimus, steroids, and mycophenolate mofetil was administered.
Main Results:
- Successful bone healing and ligamentoplasty were achieved.
- At 2 years post-transplant, the patient demonstrated elbow flexion, wrist extension, and finger function in both arms.
- Electromyography confirmed intrinsic muscle activity, and sensory recovery was noted. Patient reported satisfaction with regained autonomy and body image.
Conclusions:
- Bilateral arm transplantation is a feasible option for proximal-level arm amputees.
- Patient education on risks and limits, along with compliance and determination, are crucial for successful outcomes.
