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Forearm Replantation for a Patient Presented with Major Amputation Injury: A Case Report

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eISSN 2287-1683 pISSN 1738-8767 Journal of Trauma and Injury Vol. 29, No. 4, December, 2016 http://dx.doi.org/10.20408/jti.2016.29.4.187

─ 187 ─

� Case Report �

� Address for Correspondence : Hyung-Kee Kim, M.D.

Department of Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea

Tel : 82-53-420-5605, Fax : 82-53-421-0510, E-mail : [email protected]

Submitted : December 2, 2016 Revised : December 2, 2016 Accepted : December 30, 2016

Forearm Replantation for a Patient Presented with Major Amputation Injury: A Case Report

Jihoon Jang, M.D., Kyoung Hoon Lim, M.D., Joon-Woo Kim, M.D.

1

, Hyung-Kee Kim, M.D.

Department of Surgery,

1

Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea

With the development of safety measures for employees who work with dangerous machinery, the frequency of amputation injuries has been decreasing with resultant decrease in replantation procedures. However, in some patients with major amputation injury, replantation is still necessary for the preservation of limb and it s function. The replanta- tion of the upper extremity (UE) is a complex and technically demanding surgical procedure. For the successful replan- tation of UE, the type of injury, reconstruction sequence, ischemic time, and other combined injury of patient should be considered. We report a case of major amputation of UE by guillotine-type injury and discuss the treatment process of this patient. [ J Trauma Inj 2016; 29: 187-190 ]

Key Words: Amputation, Replantation, Forearm

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- Journal of Trauma and Injury Vol. 29, No. 4 -

Fig. 1. (A) Flushing of severed forearm was performed through radial artery (RA), ulnar aryery (UA) with cold heparinized Hartmann’s solution; (B) The internal fixation of both ulna and radius was done by end to end with plate fixation; (C) Vascular reconstruction of RA and UA was performed by end to end anastomosis and vascular reconstruction of cephalic vein (CV) and basilic vein (BsV) was performed by interpositions with harvested greater saphenous vein; (D) The skin around cutting surface was closed with 4-0 nylon and the fasciotomy was done.

A B

C D

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─ 189 ─

Jihoon Jang, et al. Forearm Replantation for Major Amputation Injury

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REFERENCES

01) Malt RA, McKhann C. Replantation of Seved Arms. JAMA 1964; 189: 716-22.

02) Leclere FM, Mathys L, Juon B, Franz T, Unglaub F, Vogelin E. Macroreplantations of the upper extremity: a series of 11 patients. Arch Orthop Trauma Surg 2012; 132: 1797-805.

03) Meyer VE. Upper extremity replantation: a review. Eur Surg 2003; 35: 167-73.

04) Kim HK, Cho J, Huh S, Oh CW, Chung HY, Roh YN, et al.

Upper Extremity Replantation for Patients with Major Amputation Injury: Follow-up Results of 11 Patients. Korean J Vasc Endovasc Surg 2013; 20: 10-6.

05) Ipsen T, Lundkvist L, Barfred T, Pless J. Principles of evalua- tion and results in microsurgical treatment of major limb amputations. A follow-up study of 26 consecutive cases 1978- 1987. Scand J Plast Reconstr Surg Hand Surg 1990; 24: 75-80.

06) Goldner RD, Nunley JA. Replantation proximal to the wrist.

Hand Clin 1992; 8: 413-25.

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- Journal of Trauma and Injury Vol. 29, No. 4 -

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Fig. 1. (A) Flushing of severed forearm was performed through radial artery (RA), ulnar aryery (UA) with cold heparinized Hartmann’s solution; (B) The internal fixation of both ulna and radius was done by end to end with plate fixation; (C) Vascular recons

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