[First case in the world of autoreplantation of a limb associated with oral administration of an immunosupressant agent (FK 506-Tacrolimus)].
This is the case of the replantation of the upper limb of a sixty year old woman. The nature of the traumatism is an avulsion of the upper limb, at the junction of the middle third and the lower third of the humerus, which has a very bad prognosis. The originality of this report is the administration of Tacrolimus (immunosuppressive molecule) in an autotransplant. Tracolimus stimulates the nerve growing back, as already demonstrated in the animal and the fetus. In this preliminary report, the use of Tacrolimus over one year showed exceptional results. Indeed, the autors noticed clinical signs of intrinsic reinervation of the hand in the territory of the ulnar and median nerve. This has been confirmed with the use of electromyography. This is, as far as we know, the first observation of such results with adults and when the level of amputation is located so high. The authors think that the use of Tacrolimus should be tested in numerous cases of nerve lesions with bad prognosis such as high ulnar nerve lesions, serious plexus suffering or even in spinal cord trauma.
Martin
D
D
Service de chirurgie plastique, chirurgie de la main, microchirurgie, Hôpital du Tondu, CHU de Pellegrin BORDEAUX. dominique.martin@chu-bordeaux.fr
Pinsolle
V
V
Merville
P
P
Moreau
K
K
Pelissier
P
P
Baudet
J
J
D000284:Administration, Oral; D001134:Arm Injuries / Q000601:surgery*; D004576:Electromyography; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D012092:Replantation / Q000379:methods*; D016559:Tacrolimus / Q000627:therapeutic use*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries
D007166:Immunosuppressive Agents; D016559:Tacrolimus