Major limb replantation: a Thai experience.
From May 1986 to December 1992, we performed 36 major limb replantations in 35 patients; 30 were complete and 6 were incomplete amputations. Twenty-eight of these patients were male. Their ages ranged from 5 to 81 years, the average being 22 years. The levels of injury were 13 hemihand, 8 wrist, 5 lower forearm, 5 upper forearm, and 5 above the elbow amputation. The degrees of injury were 8 guillotine, 14 local crush, 9 diffuse crush, and 5 avulsion amputation. There were a partial loss of digits in 4 hemihand amputations and one failure in an above-elbow amputation--a limb survival rate of 95%. The functional result was evaluated in 30 patients, one with bilateral hemihand. Most patients regained useful hand function, with 20 achieving a grade I functional result--an ability to resume original work--or grade II functional result--an ability to do some gainful work--according to Chen's criteria. The best functional results were obtained in injuries which were near the wrist joint.
Patradul
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A
Department of Orthopaedic Surgery, Faculty of Medicine, Chulalongkorn University, Thailand.
Ngarmukos
C
C
Parkpian
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000673:Amputation, Traumatic / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D001134:Arm Injuries / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005543:Forearm Injuries / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012092:Replantation / Q000379:methods*; D012189:Retrospective Studies; D013785:Thailand; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*