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Major limb replantation: a Thai experience
A Patradul1, C Ngarmukos, V Parkpian
1Department of Orthopaedic Surgery, Faculty of Medicine, Chulalongkorn University, Thailand.
Annals of the Academy of Medicine, Singapore
|July 1, 1995
Summary
This study on major limb replantations achieved a 95% limb survival rate. Most patients regained useful hand function, with best results seen in wrist-level amputations.
Area of Science:
- Reconstructive Surgery
- Microsurgery
- Trauma Surgery
Background:
- Major limb amputations present significant reconstructive challenges.
- Limb replantation offers a chance to restore function and avoid prosthetics.
Purpose of the Study:
- To evaluate the outcomes of major limb replantations.
- To assess limb survival and functional recovery rates.
- To identify factors influencing successful replantation outcomes.
Main Methods:
- Retrospective analysis of 36 major limb replantations in 35 patients (May 1986 - Dec 1992).
- Categorization of amputations by completeness, level, and mechanism of injury.
- Functional assessment using Chen's criteria for 30 patients.
Main Results:
- A limb survival rate of 95% was achieved (1 failure in 36 cases).
- Most patients (20/30) achieved Grade I or II functional results, indicating ability to resume work.
- Optimal functional outcomes were associated with replantations at the wrist joint level.
Conclusions:
- Major limb replantation is a viable option with high survival rates.
- Significant functional recovery is achievable, enabling patients to return to work.
- Replantation success is influenced by the level of amputation, with wrist-level injuries yielding the best results.