Late Results of Successful Replantation of Upper and Lower Extremities

Nasseri, M.; Voß, Hermann

doi:10.1097/00000658-197301000-00021

Cited by 13 publications

(2 citation statements)

References 3 publications

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“…Technical advances in microsurgery have resulted in a high rate of successful revascularization after major limb amputations. Earlier studies emphasized the restoration of circulation and equated this with the success of the procedure, reporting up to 94% initial survival (Berger and Millesi,1980; Brown et al, 1979; Daniel et al, 1973; Kleinert et al, 1980; Malt et al, 1972; Meyer, 1985; Midell and Loughran, 1976; Nasseri and Voss, 1973; O’Brien et al, 1974; Peacock and Tsai, 1987; Pinzur et al, 1994; Russell et al, 1984; Tamai, 1982; Wang et al, 1981; Wood and Cooney, 1986; Zhong-Wei et al, 1981). In later reports, however, it was revealed that the initial high survival rate did not translate well into successful long-term outcome (Atzei et al, 2005; Axelrod and Büchler, 1991; Battiston et al, 2007; Beris et al, 1994; Dagum et al, 2007; Daigle and Kleinert, 1991; Graham et al, 1998; Hierner et al, 1998; Ipsen et al, 1990; Sabapathy et al, 2007; Sugun et al, 2009; Wang et al, 1981).…”

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confidence: 99%

Long-term results of major upper extremity replantations

Gulgonen

Özer

2011

J Hand Surg Eur Vol

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We analyzed the long-term functional outcome in patients with major upper extremity replantations. Two patients had amputations proximal to the elbow joint, two had elbow disarticulations and five patients had amputations at the forearm. The mean age was 24 and the mean follow-up time was 18 years. Six patients have undergone secondary operations. The mean grip strength was restored to 34% of the contralateral extremity. Protective sensation was restored in all patients. According to Chen's functional recovery scale, five patients had excellent, two had good, and two had fair results. Grip strength, two-point discrimination, ranges of motion and Chen's scale did not improve after 5 years. However, Semmes-Weinstein monofilament testing and cold intolerance continued to improve up to 10 and 12 years, respectively. Replantation of an upper extremity proximal to the wrist joint satisfactorily restored the upper extremity function.

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Section: Introductionmentioning

confidence: 99%

Long-term results of major upper extremity replantations

Gulgonen

Özer

2011

J Hand Surg Eur Vol

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“…Review articles by McNeill and Wilson [12] and Engber and Hardin [13] outlined replantation surgery up to 1970. Thereafter, many reports on replantation of amputated extremities have appeared in the literature, especially from the People's Republic of China, the United States, Australia, Japan, and West Germany [14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

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confidence: 99%

Major limb, hand, and digital replantation

et al. 1979

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Successful replantation of an amputated extremity depends mainly upon the accurate repair of blood vessels, but the final goal must be complete restoration of function. Before a decision to replant is made, the extent of tissue damage, the patient's age and general condition, sex, occupation, and the patient's wishes regarding replantation are evaluated. All tissues that influence survival of the replanted part and its ultimate function must be repaired primarily. An operating microscope should always be used for the vascular and nerve repairs, especially in digital replantation. Good postoperative management is the final key for successful replantation, and includes prevention of thrombosis and adequate rehabilitation. Systemic heparinization is used in digital replantation, but is not used in major limb replantation. Rehabilitation is begun on the first postoperative day, but several reconstructive operations may be necessary on the replanted part to achieve improved function.Between May, 1959 and December, 1977, replantation operations were performed in 218 extremities of 159 patients. Thirteen of 16 major limb replantations and 181 of 204 digital replantations have survived, an overall success rate of 88%. Functional recovery has varied in each individual for several reasons, but most patients are satisfied with the function of their replanted part.Replantation of amputated extremities was a matter of interest long before the standard of medicine had reached its present level. Paintings of limb replantation or transplantation were done by the Italian artist Tiepolo in the 17th century. Hoephner [1], one of

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Macroreplantation: An overview

Kleinert

Graham

1990

Microsurgery

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Late Results of Successful Replantation of Upper and Lower Extremities

Cited by 13 publications

References 3 publications

Long-term results of major upper extremity replantations

Long-term results of major upper extremity replantations

Major limb, hand, and digital replantation

Macroreplantation: An overview

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