Factors Associated with Primary and Secondary Amputation following Limb-Threatening Upper Extremity Trauma.

Abstract:

BACKGROUND:The aim of this study was to assess the factors associated with primary and secondary amputation in patients with limb-threatening trauma to the upper extremity, describe the incidence of these injuries, and describe the procedures involved in the treatment of these difficult injuries. METHODS:A retrospective study of 49 cases (in 47 patients) with acute limb-threatening trauma of the upper extremity proximal to the carpometacarpal joint level treated with either amputation or limb salvage was performed in two urban level I trauma centers between January of 2001 and January of 2018. RESULTS:Bivariate analysis demonstrated that cases of primary amputation more frequently had a higher Injury Severity Score, higher Abbreviated Injury Scale score, more proximal fractures, more severe muscle injuries, and a larger number of major nerve injuries. Secondary amputation, compared with limb salvage, was more frequently performed in patients who were younger, in cases with a higher Injury Severity Score, where there was more proximal soft-tissue injury, in case of nonsharp mechanism of injury, and in cases that required local flap procedures for wound closure. The authors found a yearly incidence of 62 cases of acute limb-threatening upper extremity trauma per 100,000 trauma admissions. CONCLUSIONS:Multiple factors influence the surgical decision to perform primary amputation or to attempt a salvage procedure following limb-threatening upper extremity trauma. Knowing which patients will have the most favorable outcomes of a salvage procedure is important, because salvage procedures impose a greater burden on the health care system and the patient, even more so in the case of secondary amputation. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.

journal_name

Plast Reconstr Surg

authors

Nawijn F,Westenberg RF,Langhammer CG,Chen NC,Eberlin KR

doi

10.1097/PRS.0000000000006644

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

987-999

issue

4

eissn

0032-1052

issn

1529-4242

pii

00006534-202004000-00030

journal_volume

145

pub_type

杂志文章,多中心研究
  • Skeletal stability and relapse patterns after Le Fort I maxillary osteotomy fixed with miniplates: the unilateral cleft lip and palate deformity.

    abstract::The outcomes of a consecutive series of 35 adults and adolescents judged to be skeletally mature (mean 18 years) who had unilateral cleft lip and palate and had undergone Le Fort I advancement fixed with miniplates were investigated. All patients had received grafts of autogenous iliac bone and were stabilized intraop...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199412000-00004

    authors: Posnick JC,Dagys AP

    更新日期:1994-12-01 00:00:00

  • Staged excision of lentigo maligna and lentigo maligna melanoma: a 10-year experience.

    abstract:BACKGROUND:The treatment of lentigo maligna and lentigo maligna melanoma presents a difficult problem for clinicians. Published guidelines recommend a 5-mm excision margin for lentigo maligna and a 1-cm margin for lentigo maligna melanoma, yet these are often inadequate. The authors' purpose is to report their 10-year ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181bcf002

    authors: Bosbous MW,Dzwierzynski WW,Neuburg M

    更新日期:2009-12-01 00:00:00

  • Treatment of hostile midline back wounds: an extreme approach.

    abstract::The basic principles of successful wound closure remain the same: careful preoperative evaluation, removal of underlying nonviable tissue, and well-vascularized soft-tissue coverage. Many complex or "hostile" back wound closures also require stabilization of the spine and a two-layered wound closure. The use of long a...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200006000-00022

    authors: Few JW,Marcus JR,Lee MJ,Ondra S,Dumanian GA

    更新日期:2000-06-01 00:00:00

  • Progressive tension sutures to prevent seroma formation after latissimus dorsi harvest.

    abstract::The latissimus dorsi muscle flap is a versatile flap used in a variety of reconstructive procedures. The major complication reported with its use is donor-site seroma, reported to occur in 20 to 79 percent of cases. A retrospective review of 47 patients undergoing latissimus dorsi muscle harvest from April of 1998 thr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000090542.68560.69

    authors: Rios JL,Pollock T,Adams WP Jr

    更新日期:2003-12-01 00:00:00

  • Closed reduction and fluoroscopically assisted percutaneous stabilization of displaced subcondylar mandible fractures.

    abstract:BACKGROUND:Displaced subcondylar fractures of the mandible are difficult to treat. Open reduction with internal fixation carries significant risks including devascularization of the condylar segment, facial nerve injury, and scarring. Closed treatment with mandibular-maxillary fixation alone accepts a misaligned fractu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000178047.97112.fa

    authors: Boutros SG

    更新日期:2005-09-15 00:00:00

  • Malignant transformation in concurrent benign mixed tumors of the parotid and submaxillary glands.

    abstract::This patient is the only reported case of concomitant mixed tumors of the parotid and contralateral submaxillary gland. Each lesion had histologic changes consistent with different stages in the transformation of a benign to a malignant mixed tumor. Identifying premalignant disease in the parotid tumor and early prein...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198005000-00023

    authors: McGrath MH

    更新日期:1980-05-01 00:00:00

  • A Treatment Algorithm for Patients Presenting with Sagittal Craniosynostosis after the Age of 1 Year.

    abstract:BACKGROUND:Sagittal craniosynostosis typically presents shortly after birth, with a scaphocephalic head shape, and is addressed surgically for functional and aesthetic concerns. This study highlights the authors' experience with a challenging patient population: those with phenotypically mild, missed, and late-developi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003602

    authors: Ruane EJ,Garland CB,Camison L,Fenton RA,Nischal KK,Pollack IF,Tamber MS,Grunwaldt LJ,Losee JE,Goldstein JA

    更新日期:2017-09-01 00:00:00

  • Advanced Technologies to Improve Wound Healing: Electrical Stimulation, Vibration Therapy, and Ultrasound-What Is the Evidence?

    abstract:BACKGROUND:Cellular energy is required for the healing cascade to occur. A combination of cells, cytokines, chemokines, tissue perfusion, an extracellular matrix, and local forces are also required to allow for human tissue repair to proceed. Although there are many examples of treatment options, energy-based therapies...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000002680

    authors: Ennis WJ,Lee C,Gellada K,Corbiere TF,Koh TJ

    更新日期:2016-09-01 00:00:00

  • Maternal cigarette smoking during pregnancy and the risk of having a child with cleft lip/palate.

    abstract::Maternal cigarette smoking during pregnancy as a risk factor for having a child with cleft lip/palate has been suggested by several epidemiologic studies. However, most of these studies contained small sample sizes, and a clear association between these two factors could not be established. The U.S. Natality database ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006534-200002000-00001

    authors: Chung KC,Kowalski CP,Kim HM,Buchman SR

    更新日期:2000-02-01 00:00:00

  • Effects of an autologous flap combined with an implant for breast reconstruction: an evaluation of 1000 consecutive reconstructions of previously irradiated breasts.

    abstract:BACKGROUND:The goal of the authors' study was to determine whether an autologous tissue flap, when combined with an implant for breast reconstruction, reduces the incidence of implant-related complications in previously irradiated breasts. METHODS:The authors reviewed 1000 consecutive cases of implant-based breast rec...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31817d6303

    authors: Chang DW,Barnea Y,Robb GL

    更新日期:2008-08-01 00:00:00

  • Reconstruction of Large Abdominal Wall Defects Using Neurotized Vascular Composite Allografts.

    abstract:BACKGROUND:Abdominal wall vascularized composite allotransplantation is the second most common form of vascularized composite allotransplantation. Sensory and functional recovery are expected in other forms but have never been demonstrated in abdominal wall vascularized composite allotransplantation. The authors hypoth...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001584

    authors: Broyles JM,Sarhane KA,Tuffaha SH,Cooney DS,Lee WPA,Brandacher G,Sacks JM

    更新日期:2015-10-01 00:00:00

  • Augmentation Gluteoplasty: A Brazilian Perspective.

    abstract::According to recent data, augmentation gluteoplasty continues to gain popularity in the United States and globally, especially in procedures involving fat grafts. However, serious concerns about its safety have been raised over the past 2 years. Will this trend continue or has it already reached its peak? The answer d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004809

    authors: Rosique RG,Rosique MJF

    更新日期:2018-10-01 00:00:00

  • Consequences of the U.S. Food and Drug Administration-Directed Moratorium on Silicone Gel Breast Implants: 1992 to 2006.

    abstract::The U.S. Food and Drug Administration silicone gel breast implant moratorium occurred 25 years ago. The immediate and long-term consequences of the moratorium are reviewed and assessed. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000004284

    authors: Cole NM

    更新日期:2018-05-01 00:00:00

  • A simple technique for closure of a palatal fistula using a conchal cartilage graft.

    abstract::A simple technique for closure of a palatal fistula using a conchal cartilage graft as a substitute for nasal lining flaps is reported. This graft simplifies the repair of the palatal fistula and protects the suture line of the oral covering flaps from recurrence. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199108000-00029

    authors: Matsuo K,Kiyono M,Hirose T

    更新日期:1991-08-01 00:00:00

  • Molecular and cellular characterization of mouse calvarial osteoblasts derived from neural crest and paraxial mesoderm.

    abstract:BACKGROUND:Cranial skeletogenic mesenchyme is derived from two distinct embryonic sources: mesoderm and cranial neural crest. Previous studies have focused on molecular and cellular differences of juvenile and adult osteoblasts. METHODS:To further understand the features of mouse-derived juvenile osteoblasts, the auth...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000279491.48283.51

    authors: Xu Y,Malladi P,Zhou D,Longaker MT

    更新日期:2007-12-01 00:00:00

  • The Current Role of Three-Dimensional (3D) Printing in Plastic Surgery.

    abstract::Since the advent of three-dimensional (3D) printing in the 1980s, it is now possible to produce physical objects from digital files and create 3D objects by adding one layer at a time following a predetermined pattern. Due to the continued development of inexpensive and easy- to- use 3D printers and bioprinting, this ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000150

    authors: Kamali P,Dean D,Skoracki R,Koolen PG,Paul MA,Ibrahim AM,Lin SJ

    更新日期:2016-01-21 00:00:00

  • What's New in Acellular Dermal Matrix and Soft-Tissue Support for Prosthetic Breast Reconstruction.

    abstract::Of the nearly 90,000 implant-based breast reconstructions performed in the United States, the majority use internal soft-tissue support. Aesthetically, these constructs may allow for better positioning of prosthesis, improve lower pole expansion, and increase projection. They may have particular utility in direct-to-i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000003950

    authors: Kim JYS,Mlodinow AS

    更新日期:2017-11-01 00:00:00

  • Infracture technique for reduction malarplasty with a short preauricular incision.

    abstract::The infracture technique for reduction malarplasty has been widely used as an aesthetic surgical procedure in northeast Asia. Since 1988, the authors' original method of infracture technique was performed through the combined approach of intraoral and temporopreauricular incision, which may leave a rather long scar on...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000110217.60491.56

    authors: Yang DB,Chung JY

    更新日期:2004-04-01 00:00:00

  • Quantitative analysis of blood and fat in suction lipectomy aspirates.

    abstract::This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198678060-00009

    authors: Goodpasture JC,Bunkis J

    更新日期:1986-12-01 00:00:00

  • The role of acellular dermal matrices in capsular contracture: a review of the evidence.

    abstract::Despite advances in breast implant surgery, capsular contracture remains a challenging sequela of reconstructive and cosmetic breast implant surgery. Although there are established modalities for treatment, most recently, acellular dermal matrix products have been suggested to have a role in preventing or diminishing ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e318262df58

    authors: Basu CB,Jeffers L

    更新日期:2012-11-01 00:00:00

  • Comparative study of different combinations of microvascular anastomoses in a rat model: end-to-end, end-to-side, and flow-through anastomosis.

    abstract:BACKGROUND:This study aimed to compare several microvascular anastomotic techniques by patency rate using a free flap model in rats. METHODS:A microsurgical transfer model of a pectoral skin flap to the cervical region was used. In experiment 1, 120 rats were divided into four groups (n = 30 in each group) depending o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31817d62c5

    authors: Miyamoto S,Okazaki M,Ohura N,Shiraishi T,Takushima A,Harii K

    更新日期:2008-08-01 00:00:00

  • Comparison of vertical and oblique rectus abdominis myocutaneous flaps for pelvic, perineal, and groin reconstruction.

    abstract:BACKGROUND:Wound complications after perineal and groin obliterative procedures are a significant cause of morbidity, particularly following chemoradiation therapy. Vertical and, increasingly, oblique rectus abdominis myocutaneous flaps have been used to fill potential dead space and bring healthy, vascularized tissue ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000324

    authors: Combs PD,Sousa JD,Louie O,Said HK,Neligan PC,Mathes DW

    更新日期:2014-08-01 00:00:00

  • Refinements in face lifting: enhanced facial contour using vicryl mesh incorporated into SMAS fixation.

    abstract::As we have gained experience with the extended superficial musculoaponeurotic system (SMAS) technique in face lifting, refinements in our procedure have led to increased consistency in results. The important factors that have led to our technical modifications include the following: (1) the significance of the retaini...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200001000-00046

    authors: Stuzin JM,Baker TJ,Baker TM

    更新日期:2000-01-01 00:00:00

  • Two-dimensional cephalometric analysis of the effects of subperiosteal palatal soft-tissue expansion in growing cats.

    abstract::The feasibility and possible effects of palatal soft-tissue expansion in palatal repair were studied. A prospective longitudinal animal experiment was performed in 75 growing cats assigned to 5 groups. In 31 cats, a midline defect was made, and bipediced flaps were raised at the age of 8 weeks (stimulated Langenbeck o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199706000-00023

    authors: Van Damme PA,Maltha JC,Kuijpers-Jagtman AM,Freihofer HP,Van't Hof MA

    更新日期:1997-06-01 00:00:00

  • Reconstruction of the distal ulnar epiphysis with vascularized proximal fibula including epiphysis in children after osteochondroma resection: report of two cases.

    abstract:BACKGROUND:Osteochondromas, especially multiple hereditary osteochondromas, usually cause various deformities of the joints. The authors sometimes find ulnar shortening and acquired wrist varus deformity in distal ulnar osteochondromas and even radial head dislocation resulting in ulnar shortening. In this study, the a...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182a3bf98

    authors: Yang YF,Zhang GM,Huo ZQ,Xu ZH,Xu DC

    更新日期:2013-11-01 00:00:00

  • Relationship of the zygomatic facial nerve to the retaining ligaments of the face: the Sub-SMAS danger zone.

    abstract:BACKGROUND:The transition zone between cheek superficial musculoaponeurotic system (SMAS) and malar SMAS is difficult to raise because of proximity of zygomatic nerve branches. The authors attempted to clarify the three-dimensional anatomy of the retaining ligaments in relation to nerve branches in this area. METHODS:...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182789c5c

    authors: Alghoul M,Bitik O,McBride J,Zins JE

    更新日期:2013-02-01 00:00:00

  • Treatment of sternal nonunion with the Dall-Miles cable system.

    abstract::We have used this technique in two patients. One had early sternal dehiscence with presternal infection, and the other had late sternal nonunion. Uncomplicated sternal union was achieved in both patients. The cables were nonpalpable in both patients, but they were removed in one patient at that patient's request. This...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200010000-00019

    authors: Eich BS,Heinz TR

    更新日期:2000-10-01 00:00:00

  • Objective assessment of keloid scars with three-dimensional imaging: quantifying response to intralesional steroid therapy.

    abstract:BACKGROUND:Treatment of keloid scars poses a significant challenge. Assessment of treatment response and research in this area depend on the availability of objective, accurate, and reproducible outcome measures. At present, scars are assessed using subjective grading systems, or with cumbersome investigations such as ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000252505.52821.76

    authors: Ardehali B,Nouraei SA,Van Dam H,Dex E,Wood S,Nduka C

    更新日期:2007-02-01 00:00:00

  • Rat mandibular distraction osteogenesis: Part I. Histologic and radiographic analysis.

    abstract::The application of distraction osteogenesis to craniofacial surgery has altered the approach and treatment of congenital and acquired craniofacial defects. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been described extensively, relatively little is known about the ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199811000-00033

    authors: Rowe NM,Mehrara BJ,Dudziak ME,Steinbreck DS,Mackool RJ,Gittes GK,McCarthy JG,Longaker MT

    更新日期:1998-11-01 00:00:00

  • Correction of enophthalmos and superior sulcus depression in the anophthalmic orbit: a long-term follow-up.

    abstract::The purpose of this study was to review the long-term results in anophthalmic patients treated for enophthalmos. The patients in our series had augmentation of the volume of their orbital contents by subperiosteal placement of room-temperature vulcanized silicone. From 1972 to 1985, sixty-three patients received subpe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198703000-00001

    authors: Sergott TJ,Vistnes LM

    更新日期:1987-03-01 00:00:00