Reconstruction and Rehabilitation Following Traumatic Hemipelvectomy and Brachial Plexus Injury

Orcutt, Thomas W.; Emerson, Charles W.; Rhamy, Robert K.; Cocke, William M.

doi:10.1097/00005373-197408000-00005

Cited by 15 publications

(6 citation statements)

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“…Several designs are available, but all are cumbersome, heavy, and impractical for daily use. The literature indicates that almost all patients prefer to use a wheelchair, 2,32,33 and the current authors' experience confirms this. Severe depression is common, and few, if any, patients are able to return to work.…”

Section: B 3d 3csupporting

confidence: 79%

Management of Partial Traumatic Hemipelvectomy

Wang¹,

Zhou²,

Shen³

et al. 2013

Orthopedics

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Partial traumatic hemipelvectomy is a devastating condition. Although by definition the affected limb is not totally transected from the trunk because of retained soft tissue, the reported mortality rate is actually higher than in complete traumatic hemipelvectomy. Between January 2000 and December 2011, a total of 917 patients were admitted to the authors' institution for pelvic fracture. Seven of these patients met the criteria for partial traumatic hemipelvectomy. All 7 patients had multiple associated injuries and met the criteria for Baskett class IV hypovolemic shock on arrival at the emergency department. The amount of bleeding was the greatest issue, and control of hemorrhage and rapid blood transfusion were the initial goals. Abdominal aorta balloon occlusion, laparotomy and packing, and pelvic external fixation were useful to control bleeding. Two patients died during the initial resuscitation phase. Angiography (digital subtraction or computed tomographic) was performed in 4 patients but did not provide any treatment-altering information. Limb preservation was attempted in 2 patients; both of these patients eventually required hindquarter amputation. One patient died, and the second patient survived after a difficult postoperative course. The best results were obtained in 3 patients who underwent completion of the hindquarter amputation within 24 hours of trauma. All patients became wheelchair dependent, and no patient was able to return to work. Early completion of hindquarter amputation after hemorrhaging has been controlled is recommended in patients with partial traumatic hemipelvectomy. Angiography did not prove useful in decision making.

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Section: B 3d 3csupporting

confidence: 79%

Management of Partial Traumatic Hemipelvectomy

Wang¹,

Zhou²,

Shen³

et al. 2013

Orthopedics

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“…The use of a full-thickness gluteus myocutaneous flap was reported [18,24]. The used musculocutaneous flaps included thoracoabdominal, rectus abdominis, latissimus dorsi, contralateral gluteus flaps, or a composite island flap [10,27,33,34,36]. Split-thickness skin grafting able to withstand the stress generated by prosthesis was also reported [10,13].…”

Section: Discussionmentioning

confidence: 99%

“…As these injuries will significantly influence the patient's potential for rehabilitation [16,18,19,36], they should be managed, provided the patient's condition permits.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Hemipelvectomy

Labler

Trentz²,

Keel

2005

Eur J Trauma

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“…The use of several techniques of musculocutaneous flaps have been described in the literature (full-thickness gluteus myocutaneous, thoracoabdominal, rectus abdominal, latissimus dorsi, contralateral gluteal flaps, or a composite island flap). 1,14,21,[37][38][39][40][41][42] There have also been reports in the literature where they have used flaps and skin of the already amputated leg. 43 Nevertheless, this kind of definitive closure techniques requires experienced physicians in reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%