Lower leg replantation—Decision‐making, treatment, and long‐term results

Hierner, R.; Berger, A.; Frederix, Peter Reynders

doi:10.1002/micr.20380

Cited by 25 publications

(26 citation statements)

References 48 publications

(67 reference statements)

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“…Only if the patient can walk independently with the transplanted legs is the procedure warranted. Lower limb replantation has typically been contraindicated due to reported poor results . Recently encouraging results of leg replantation have been published .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral Transfemoral Lower Extremity Transplantation: Result at 1 Year

Cavadas¹,

Thioné²,

Carballeira³

et al. 2013

American Journal of Transplantation

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Section: Discussionmentioning

confidence: 99%

“…Lower extremity transplantation has typically been contraindicated, assuming the theoretical risks would outweigh the benefits. Classically, even lower limb replantation after traumatic amputation has been discouraged , although good results have been reported in below‐knee (BK) replantations recently .…”

Section: The Recipientmentioning

confidence: 99%

Bilateral Transfemoral Lower Extremity Transplantation: Result at 1 Year

Cavadas¹,

Thioné²,

Carballeira³

et al. 2013

American Journal of Transplantation

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“…In the majority of the publications the authors do not distinguish between reported cases of distal and proximal lower limb amputations/replantations. They usually evaluate these cases as a homogenous group, [11] albeit physiological factors influencing the outcome of replantations are more advantageous in case of lower leg replantations [12] than those of replantations performed above the knee and in the mid-third of the thigh.…”

Section: Discussionmentioning

confidence: 99%

Above-knee amputation followed by femoral replantation: 21-year follow-up results after lower limb replantation

Renner¹,

Szentirmai²,

Sántha³

et al. 2016

Eklem Hastalik Cerrahisi

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Above-knee amputation followed by femoral replantation:21-year follow-up results after lower limb replantation Literature on lower limb replantation continues to lack uniformity. Primary amputation is performed because of potentially life threatening postoperative complications and availability of technically refined lower limb orthoses, furthermore, safety and cost reduction are also taken into consideration.[1] After replantation at this level of the limb, when the decision was made based on several well known score systems, the replanted limb is usually amputated immediately after the appearance of the first symptoms of complications. [2][3][4] According to some authors, heterotopic replantation of the lower limb is indicated only in children [5,6] and in case of bilateral amputation. [7,8] In our case, we performed the replantation in 1986, when microsurgery was in a very early phase of development, furthermore, no score systems predicting the expected success of the replantation existed [such as Mangled Extremity Score (MESS), Limb Salvage Index (LSI), Predictive Salvage Index (PSI), Nerve injury-Ischemia-Soft tissue injurySkeletal injury-Shock-Age of patient (NISSSA), Hannover Fracture Scale (HFC)-97 version, Battiston ÖZ Bu yazıda, femurun orta üçte birinde travmatik ampütasyon sonrası ciddi replantasyon komplikasyonlarının başarılı tedavisi sunuldu. Bildiğimiz kadarıyla, literatürde benzeri bir olgu bildirilmemiştir. Otuz sekiz yaşında sağlıklı bir erkek sağ femurun orta üçte birinde travmatik ampütasyona maruz kaldı. Replantasyon uygulandı. Oligüri ve anüri gelişti ve hemofiltrasyon ve hemodiyaliz ile başarıyla tedavi edildi. Altı yıl sonra, hasta ortopedik ayakkabı giyerek yürüdü ve uzuvda koruyucu sensibilite düzeldi. Proksimal alt uzuv replantasyonunun ciddi komplikasyonları başarıyla tedavi edilebilir ve uzuv kurtarılabilir.Anahtar sözcükler: Ampütasyon; komplikasyonlar; alt ekstremite; replantasyon; travmatik. ABSTRACTIn this article, we report successful treatment of serious complications of replantation after traumatic mid-third femoral amputation. To the best of our knowledge, no similar case has been reported in the literature. A 38-year-old healthy male sustained a mid-third right traumatic femoral amputation. We performed replantation. Oliguria and anuria occurred and were treated successfully with hemofiltration and hemodialysis. Six years later, patient walked wearing orthopedic shoes and also protective sensibility recovered on the limb. Serious complications of proximal lower limb replantation can be treated successfully and the limb is saveable.

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“…Treatment options for amputation-like injuries of the lower limb are either aimed at the provision of a stump that is suitable for early prostheses fitting or reconstruction. 33 The advantage with primary amputation is a rapid rehabilitation process and a quick return to a functional life. Delaying an inevitable amputation leads to greater: length of hospitalization, physical and psychological deconditioning, disability, financial burden, false hope and risk of death.…”

Section: Discussionmentioning

confidence: 99%

The 2009 Sydney shark attacks: case series and literature review

Rtshiladze

Andersen

Nguyen

et al. 2011

ANZ Journal of Surgery

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New paradigms for the management of major trauma patients have emerged over the last decade. We consider recent advances in the understanding of pre-hospital tourniquet use, rapid transit to the operating suite and damage control surgery, and examine how they impacted on the management of our patients. Very little is known about the microbiology of shark bites. Organisms from sea water, the patient's skin and the shark's mouth must all be considered when selecting appropriate antimicrobial prophylaxis. The planning of definitive surgery in severe limb trauma is dependent on the interactions of a number of factors including physical, psychological and social issues. The decision to ultimately replant or amputate the effected limb is best made in union with the patient and their family.

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Lower leg replantation—Decision‐making, treatment, and long‐term results

Abstract: Our results as well as those of other large series show that lower leg replantation is still worthwhile in a well selected patient group, contrary to what is believed by an increasing number of orthopaedic and trauma surgeons.

Cited by 25 publications

References 48 publications

Bilateral Transfemoral Lower Extremity Transplantation: Result at 1 Year

Bilateral Transfemoral Lower Extremity Transplantation: Result at 1 Year

Above-knee amputation followed by femoral replantation: 21-year follow-up results after lower limb replantation

The 2009 Sydney shark attacks: case series and literature review

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