Long-term results after total and subtotal macroamputations of the upper limb

Long-term results after total and subtotal macroamputations of the upper limb Using our personal series of 65 patients operated on between 1982 and 1993 (upper arm: n = 18, proximal and middle forearm: n = 32, distal forearm and wrist level: n = 15) and the results of an extensive literature review the following criteria were evaluated: (1) survival rate, (2) possible individual motor and sensory functions of the extremity, (3) global upper extremity function judged according to Chen’s classification, (4) socioeconomic aspects, and (5) number and nature of local and/or systemic complication and the subjective judgment by the patient. The survival rate of upper limb replantation, which only means perfect restoration of viability, is about 76–92.3%. As the amputation level proceeds distally there is an increase in individual motor and sensory functions of the “functional chain upper extremity‘’. Taking grades I and II results together, a “functional extremity” can be reconstructed at the upper arm level in 22–34%, at the proximal forearm level in 30–41% and at the distal forearm level in 56–80% of cases. All patients needed at least two secondary operative procedures. Five of 65 patients underwent reamputation because of postoperative complications. Since the functional results after replantation are at least equal (proximal level) or even far superior (distal level), some protective sensation of the hand can be expected even at the most proximal levels; together with the psychological impairment caused by disruption of body integrity, this justifies reconstruction being performed if possible. Reasonable function can be expected, the risk for the patient is low, and most wish to go ahead with the procedure. The higher cost and the number of operations needed, as well as the long postoperative care and longer time of disability after replantation, are justified by a significant incease in quality of life. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Long-term results after total and subtotal macroamputations of the upper limb

Loading next page...
 
/lp/springer_journal/long-term-results-after-total-and-subtotal-macroamputations-of-the-z0rubIjpTX
Publisher
Springer-Verlag
Copyright
Copyright © 2005 by Springer-Verlag
Subject
Medicine
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-005-0733-3
Publisher site
See Article on Publisher Site

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial