[Muscular elementarization in the "borderline" replantation and revascularization of the forearm]

In order to avoid the risks of local and general complications encountered in replantations after long ("critical") periods of ischemia, or in cases of severe open fractures with crushed muscles, a so-called "muscle elementarization" technique has been devised. This technique consists of removing the muscular masses which have undergone prolonged ischemia with a priority for the least important muscles. In this manner, we believe that edema and the consequent risks of compartment syndromes as well as of life threatening complications can be reduced. Functional impairment is limited as well. Eleven cases of severe crushing or critical time limit ischemia replantation have been treated in this manner without any complications.