[Cross-forearm replantation in bilateral amputation].
We report the case of a 27-year-old patient who sustained a traumatic amputation of his 4 limbs. For the right upper limb, the site of amputation was at the level of the upper third of the forearm. For the left upper limb, the site of amputation was at the level of the Cower third of the forearm. In both cases, the loss of soft tissue was so extensive that hand replantation was impossible in the initial position. In such an unusual case, replantation of the right hand to the left side was attempted in this young patient. Osteosynthesis of the radius to the ulna in supination was performed, and arteries, veins, nerves and tendons were repaired. The other segments of amputated limbs were debrided and cleaned. Within a year, protective sensibility was restored in the replanted hand, but intrinsic muscles were paralysed. Secondarily, transfer of thumb opposition and capsulorrhaphy at the level of the metacarpophalangeal joints of long fingers were performed in order to provide a useful key-grip between the three first fingers.
Barraud
O
O
Clinique du Vivarais, Aubenas.
Thouveny
A
A
de Peretti
F
F
Giboin
P
P
Perraud
M
M
Argenson
C
C
D000328:Adult; D000673:Amputation, Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000592:standards; D006230:Hand Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D011884:Radius / Q000601:surgery; D012092:Replantation / Q000379:methods* / Q000592:standards; D013484:Supination; D014457:Ulna / Q000601:surgery
Replantation croisée d'avant-bras dans une amputation bilatérale.