Citation

Venkatramani H, Bhardwaj P, Sabapathy SR. Injury 2019; ePub(ePub): ePub.

Affiliation

Dept. of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, India. Electronic address: rajahand@gmail.com.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.injury.2019.10.059

PMID

31761421

Abstract

Replantation still remains the best form of reconstruction following major upper limb amputations. Regaining a functional limb is a challenge in avulsion amputations when there is entire loss of a compartment as it happens in proximal third of forearm amputations or when the avulsion occurs through the musculotendinous junction. In these circumstances, primary repair of the long flexors or extensors is not possible and options of secondary tendon transfers do not exist due to lack of donor tendons. These factors could weigh in negatively in making the decision for replantation at the time of presentation. We are presenting a series of 5 cases of avulsion amputation of the forearm wherein the functional outcome was enhanced by secondary Free Functional Muscle transfers (FFMT) using gracilis for finger flexion. Outcome scores improved from Chen IV to II in three patients and to III in two patients. The feasibility of gaining useful outcome through secondary procedures like FFMT should serve as an encouragement to extend the indications for replantation in avulsion amputations of the forearm.

Copyright © 2019. Published by Elsevier Ltd.

Language: en

Keywords

Flexor reconstruction and free functioning muscle transfer; Forearm amputation; Major replantation