Korean J Vasc Endovasc Surg.
2013 Feb;29(1):10-16. 10.5758/kjves.2013.29.1.10.
Upper Extremity Replantation for Patients with Major Amputation Injury: Follow-up Results of 11 Patients
- Affiliations
-
- 1Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
- 2Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
- 3Department of Plastic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
- 4Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ywkim@skku.edu
- KMID: 1430458
- DOI: http://doi.org/10.5758/kjves.2013.29.1.10
Abstract
- PURPOSE
To report follow-up data on upper extremity (UE) macroreplantation in patients with traumatic amputation injuries.
METHODS
Between 1996 and 2003, 11 patients underwent UE macroreplantation at a single institution. All patients had an open fracture (n=9; upper arm, 5; forearm, 4) or an open dislocation of the elbow (n=2), combined with neurovascular and soft tissue transection injuries. The replantation procedures were performed on an emergency basis by a multi-departmental team. The mean warm ischemic time was 328 minutes (range, 165 to 480 minutes). Functional recovery of the replanted UE was evaluated with Chen's classification system, and patient satisfaction was determined using Russell's questionnaire; periodic examinations were conducted over a minimum follow-up period of 2 years.
RESULTS
Early complications consisted of 2 arterial thromboses, 1 soft tissue infection resulting in sepsis, and 1 episode of acute renal failure; UE reamputation was required in 2 patients. As a result, limb salvage was achieved in 82% of patients (9/11). A functional extremity, defined as grades I and II using Chen's criteria, was preserved in 33.3% of patients with successfully replanted limbs. Despite the objectively poor rate of function preservation, 89% of patients who had successful replantation procedures were satisfied with the results.
CONCLUSION
Even though the functional recovery rate was low, UE macroreplantation resulted in acceptable limb salvage rates and good patient satisfaction.
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