KMID : 0904020130290010010
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Journal of Korean Society for Vascular Surgery 2013 Volume.29 No. 1 p.10 ~ p.16
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Upper Extremity Replantation for Patients with Major Amputation Injury: Follow-up Results of 11 Patients
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Kim Hyung-Kee
Cho Ja-Yun Huh Seung Oh Chang-Wug Chung Ho-Yun Roh Young-Nam Kim Young-Wook
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Abstract
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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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KEYWORD
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Amputation, Upper extremity, Replantation
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