Major limb replantation in children

Daigle, Jean Pierre; Kleinert, James M.

doi:10.1002/micr.1920120312

Cited by 57 publications

(29 citation statements)

References 45 publications

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“…[2][3][4][5][6][7] The overall success rate in our study was 89.8% (167/186). The patients who did not fulfil our inclusion criteria were treated promptly with an appropriate procedure except for those with strong contraindications to major limb reimplantation, such as multiple injuries, a prolonged warm ischaemic time greater than 12 hours and multilevel amputation with severe crush injuries.…”

Section: Discussionmentioning

confidence: 90%

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Prognostic factors for major limb re-implantation at both immediate and long-term follow-up

Waikakul

Vanadurongwan

Unnanuntana

1998

The Journal of Bone and Joint Surgery. British volume

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We performed a prospective study in 186 patients with a minimum follow-up of two years in order to attempt to predict successful major re-implantation of the upper limb. There were 137 men and 49 women with 24 amputations of the palm, 75 of the wrist, 50 of the forearm, 9 disarticulations through the elbow, and 28 amputations through the upper arm.The degree of injury to the amputated segment and the stump were good predictors of the rate of success and the final outcome. Adequate preservation, contraction of the muscle in the amputated part after stimulation, the level of injury and a smoking habit were fair indicators, but the serum potassium concentration in the amputated segment was the best objective predictor. When it is higher than 6.5 mmol/l 30 minutes after re-perfusion, re-implantation should be avoided. A high systemic venous serum potassium concentration was also found before clinical signs of the re-perfusion syndrome were seen.

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Section: Discussionmentioning

confidence: 90%

“…Most articles simply describe the authors' experience. [2][3][4][5][6] Some have tried to use an algorithm for the treatment of traumatic amputation, 7 but the measurements and assessment have been subjective and the numbers of patients small. We have tried to improve the quality of prediction and decision-making for major reimplantation of the upper limb.…”

mentioning

confidence: 99%

Prognostic factors for major limb re-implantation at both immediate and long-term follow-up

Waikakul

Vanadurongwan

Unnanuntana

1998

The Journal of Bone and Joint Surgery. British volume

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“…[29][30][31] Therefore the missing limb can adversely affect the child's psychosocial development, replantation must be attempted in all amputation injuries of the children. Replantation was attempted in all cases admitted with total amputations.…”

Section: 2223mentioning

confidence: 99%

Analysis of Hand Injuries in Children Between 0-6 Years of Age

Özdemir¹,

Karaltin²,

Yoğun³

et al. 2015

Turkiye Klinikleri J Pediatr

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M otor development is the process by which an organism gains mobility, in parallel with physical growth and the development of the central nervous system. In children, mobility develops through a process starting with reflexes and resulting in a high level of coordinated motor skills. Hand injuries occurring in early childhood may adversely affect this development.Turkiye Klinikleri J Pediatr 2015;24(3) 89Analysis of Hand Injuries in Children Between 0-6 Years of Age A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The motor development of the upper extremity and hand is actually a result of learning the intentional and fine motions in correlation with the physical growth, central nervous system differentiation and acquired cognitive abilities which are gained in early childhood. Therefore, such hand injuries in early ages may impair the process as whole. We aimed to investigate the epidemiology, etiology and the treatment outcomes in very young patients suffering from the hand injuries in this study. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective investigation of records of 507 patients, who admitted to our emergency department at last five years, between 0-6 years of age were analyzed according to etiology, the type of injury, anatomical localization of the injury, treatment approach and outcome. R Re es su ul lt ts s: : Most of the hand injuries were simple injuries (75.3%) and occured at home (72.6%). The most frequent cause of injuries was contusion (55%) and most frequent injuried site of the hand was detected as finger. Female to male ratio was 1:1.5 and right hand to left hand ratio was 2:1. C Co on nc cl lu us si io on n: : The hand injuries in the very young population seems to be common and the investigation of the etiology and type of occurrence might give us new and better modalities in preventing such injuries. K Ke ey y W Wo or rd ds s: : Child; hand injuries; accidents, home Ö ÖZ ZE ET T A Am ma aç ç: : Üst ekstremite ve el motor gelişimi fiziksel büyüme ve merkezi sinir sistemi farklıla-şması ile ilişki içindedir. Edinilmiş bilişsel hareketlerin öğrenilmesi erken çocukluk döneminde oluşur. Çocukluk çağında görülen el yaralanmaları bu süreci bozar. Bu çalışma çocukluk çağı el yaralanmalarının epidemiyoloji ve etiyolojisinin ve tedavi sonuçlarının araştırılması amacıyla yapıldı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Son beş yılda kurumumuz acil birimine başvuran ve 507 hasta incelendi. bulgular yaralanmanın görüldüğü yaş aralığına, yerleşimine ve tedavi süreçlerine göre değerlendirildi. B Bu ul lg gu ul la ar r: : El yaralanmalarının çoğunlukla basit yaralanma (%75.3) olduğu ve evde (% 72.6) oluştuğu, en sık kontüzyon tarzı (% 55) olduğu, ve en sık parmak yaralanması olduğu görüldü. Kadın erkek oranı 1:1.5 ve sağ el sol el oranı 2:1 bulundu. S So on nu uç ç: : Çocukluk çağında da el yaralanmalarının sık görüldüğü düşünüldü. Etyoloji ve sıklık incelemesi, bu yaralanmaların önlenmesi bakımından yeni ve uygun yöntemler önerebilir.A An na ah h t ta ...

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“…12 Another series with 3 distal forearm or wrist-level replants reported that 2 patients required revision amputations. 13 One report of a successful pediatric distal forearm level replant contains little information regarding surgical technique and few details of the functional results. 14 Of the papers discussing specifically hand replantations in the pediatric population, we were unable to identify any that discussed the particular challenge and outcomes of an amputation between the cartilaginous anlages of the growing carpus.…”

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confidence: 99%