Role of temporary arterial shunt in the reimplantation of a traumatic above-elbow amputation.
Although the feasibility of reimplantation has increased greatly with the development of new surgical techniques, long-term functional prognosis is unpredictable. Injury to a major nerve is an important factor in long-term outcome, and prolonged ischemia time also has a negative effect. We present a 26-year-old woman whose right arm was sectioned above the elbow in an accident. The limb presented a complete section, with soft tissue loss of the humeral artery and vein, basilic vein, and cephalic vein. Median and radial nerve tissue was missing, and a supracondylar fracture with substantial loss of the humerus was also observed. During reimplantation surgery, a temporary arterial shunt reduced ischemia time. A venous and arterial bypass was performed, and the 12-month results were good.
Davins
Meritxell
M
Department of Vascular Surgery, Sana Creu i Sant Pau Hospital, Barcelona, Spain. mdavins@santpau.es
Llagostera
Secundino
S
Lamas
Claudia
C
López
Susana
S
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods*; D001132:Arm / Q000098:blood supply / Q000601:surgery; D001134:Arm Injuries / Q000601:surgery*; D001158:Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D012092:Replantation / Q000379:methods*; D016896:Treatment Outcome