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This unfortunate man in his 40s suffered an
amputation of his left forearm at the distal two-thirds level right at the
musculocutaneous junction. He was transferred to our institution for limb
salvage with replantatin.
He underwent microvascular replantation after shortening the
radius and ulna each by 3 centimenters. Primary repair of the radial and ulnar
arteries were performed, as well as the median, ulnar and radial nerves.
Tendons were weaved back into their respective muscle bellies.
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Preoperative views and radiographs above. |
The patient was treated with dextran
post-operatively for 5 days and late required a skin graft of the volar forearm.
He underwent post-operative hand therapy.
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Postopeative views above depict relatively good finger flexion and
extension at roughly 1 year. For a full assessment of function,
click on the video link below. |
The
hand was replanted via the radial artery
and cephalic vein. An implantable
Doppler probe was used to monitor
post-operative blood flow in the
replanted hand. The volar forearm
wound had to be left open as a result of
the massive edema that followed.
For a remarkable video of postoperative function click on the video link here
(requires Quicktime):
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