Evaluation of functional recovery after upper limb replantation Evaluation of functional recovery after upper limb replantation
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Keywords
Replantation, amputation, vascular repair, limb trauma, revascularization, microsurgery
Abstract
Background: Although it is not possible always, reconstruction of defects with tissue such as defect in the original tissue usually results in best functions and esthetic outcomes. Therefore, replantation of an amputated part is superior to any other method of reconstruction mainly when the condition of the amputated part is good. The goal of replantation after amputation is function. Returning of circulation to an amputated part does not, by itself, mean success. Therefore, replantation that will not lead to a useful activity should be avoided. This is usually the case with severely crushed and extensively avulsed limbs.
Objectives: evaluation of functions’ outcome after replantation.
Patients and Methods: This study deals with 18 patients (14 males, 4 females) with different injuries. Severely crushed and extensively avulsed limbs have been excluded from repair. The level of injury involved an arm in two patients, an elbow in one, a forearm in two, a palm in two, a thumb in two, and fingers in nine. The patients’ age ranged between 2 and 55 years, during the period between January 2012 and February 2016.
Results: In all the cases, replantation of the amputated part was successful; however, there were variations in functional recovery among the cases: in three cases, the functional recovery was very good, in five, it was good, in eight, it was fair, and in two, it was poor.
Conclusions: Replantation should be tried for most amputation cases, as it has a superior aesthetic and functional result and serves a major psychological benefit for the patients. High success in a rat can be achieved when one chooses to replant an amputated part in good condition, all the structures are repaired at the time of the primary operation, and there exist excellent post-surgery physiotherapy and good patient compliance.
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