Secondary reconstructive surgery following major upper extremity replantation.

Abstract:

BACKGROUND:Little literature currently exists on reconstructive strategies following successful upper extremity replantation. The authors hypothesized that the type of secondary surgery would vary predictably depending on mechanism and amputation level. METHODS:The authors performed a retrospective review of upper extremity replantations performed at their institution between 2003 and 2012. The mean follow-up period was 3 years. Patient, injury, and surgical demographics, as well as replantation survival rates and secondary surgical procedures, were recorded. RESULTS:Forty-five upper extremity replantations met inclusion criteria and the survival rate was 89 percent (n = 40). In 40 cases of successful replantation, the average number of secondary surgical procedures was three per patient (range, zero to seven). The most common reconstructive procedures were soft-tissue coverage (n = 24), tenolysis (n = 24), free functioning muscle transfer (n = 18), and tendon transfer (n = 14). For upper arm replantations, soft-tissue coverage was the most common secondary surgery; free functioning muscle transfer was the most common for amputations between the elbow and mid-forearm; tenolysis was the most common secondary procedure performed for amputations of the distal forearm to wrist. CONCLUSIONS:Proximal-level amputations commonly required soft-tissue coverage. Amputations through the proximal forearm and elbow often underwent free functioning muscle transfer, and tenolysis was the most common secondary surgery following distal forearm and wrist amputations. Secondary surgery could be predicted based on the anatomic levels of injury.

journal_name

Plast Reconstr Surg

authors

Fufa D,Lin CH,Lin YT,Hsu CC,Chuang CC,Lin CH

doi

10.1097/PRS.0000000000000538

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

713-720

issue

4

eissn

0032-1052

issn

1529-4242

pii

00006534-201410000-00024

journal_volume

134

pub_type

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