Minimally invasive shortening humeral osteotomy to salvage a through-elbow amputation.
OBJECTIVE
Determine the efficacy of a novel surgical technique to salvage a through-elbow amputation and avoid revision transhumeral amputation.


METHODS
A 23-year-old soldier presented after sustaining a through-elbow amputation in a close-range blast injury with inadequate soft tissues to obtain closure over the distal humerus. A 2-cm anterior incision was made and a shortening osteotomy with percutaneous submuscular osteosynthesis was done. A myodesis was performed and a tension-free primary closure of the soft tissue envelope obtained.


RESULTS
At 3 months postoperatively the osteotomy and soft tissue envelope were healed. At 2-year follow-up the patient reports using a body-powered prosthesis for ADLs and recreational hobbies, citing excellent rotational control and ease of prosthetic suspension.


CONCLUSIONS
Minimally invasive shortening humeral osteotomy in the setting of a through-elbow amputation is a safe and effective procedure, which allows primary soft tissue closure, prevents the need for more proximal amputation, and allows for ease of prosthetic fitting and suspension.
Beltran
Michael J
MJ
Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
Kirk
Kevin L
KL
Hsu
Joseph R
JR
D000673:Amputation, Traumatic / Q000601:surgery*; D001753:Blast Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008889:Military Personnel; D010027:Osteotomy / Q000379:methods*; D016879:Salvage Therapy; D017695:Soft Tissue Injuries / Q000601:surgery*; D013536:Suture Techniques; D034941:Upper Extremity / Q000293:injuries*; D055815:Young Adult